RJ 



I 

THERON-WEHDELL-KILMER-M-D- 










Class JR AAL 
Book J^AI 



Copyright^ . 



COPYRIGHT DEPOSPT. 






.8. 

hi 

R 



THE PRACTICAL CARE OF 
THE BABY. 



KILMER. 



The Practical Care of 
the Baby 



BY 

THERON WENDELL KILMER, M.D. 

Associate Professor of Diseases of Children in the New York School of 
Clinical Medicine; Assistant Physician to the Out-patient Depart- 
ment of the Babies' Hospital, New York ; Attending Physician 
to the Children's Department of the West Side 
German Dispensary, New York 



WITH SIXTY-EIGHT ILLUSTRATIONS 




PHILADELPHIA 

F. A. DAVIS COMPANY, PUBLISHERS 

1903 






Two Copir? Rtioetvpo 

CLASS A^XXb No 
/ COPY B. 






COPYRIGHT. 1903, 

BY 

F. A. DAVIS COMPANY. 
[Registered at Stationers' Hall, London, Eng.J 



Philadelphia, Pa., U. S. A. 

The Medical Bulletin Printing-house, 

1914^16 Cherry Street. 



TO 

MY WIFE AND DAUGHTER, 
Without whose Loving Help and assistance My work 

COULD NOT HAVE BEEN ACCOMPLISHED, 
THIS LITTLE BOOK IS 

AFFECTIONATELY DEDICATED. 



PREFACE. 



In writing this little book the author has simply 
regarded the mother and nurse as knowing abso- 
lutely nothing about the care of a baby. This is, as 
we all are aware, not giving due credit to the average 
mother or nurse; nevertheless many readers of good 
books on baby-care are given too great credit for 
knowing the little "ins and outs" of the care of a 
baby that in reality they do not know. How easy it 
is for an experienced nurse to say, "The infant's nap- 
kins should be changed as soon as they become 
damp," and never once think of the necessity of ex- 
plaining to the young mother how to change them ! 
Again, we hear that "baby's mouth should be washed 
before and after each feeding." How should you 
wash it? Fancy a book on "Emergencies" to read: 
"When one finds himself suddenly thrown into the 
water he should swim" ! It sounds easy, doesn't it? 

The easiest way to teach is by illustration ; hence 
the large number of illustrations. The author has in 
a few instances in this book quoted milk-formulae and 
charts from other sources than his own. To Dr. L. 
Emmett Holt, of New York, I am greatly indebted 
for valuable milk-formulae taken from his book : "The 
Care and Feeding of Children." 

New York, October, 1903. 

(vii) 



CONTENTS. 



PAGE 

Bathing 1 

The Eyes 4 

The Mouth 6 

The Skin 8 

Clothing 9 

Long Clothes Series 9 

Short Clothes Series 18 

Night-clothes 23 

Out-of-door Clothes 25 

Creeping Apron 2G 

Napkins 26 

Weight 30 

Growth (Length, Height) 32 

Development 32 

Dentition (Teething) 39 

Airing 42 

Exercise 43 

Sleep . . 44 

Bowels 47 

Constipation 52 

Diarrhoea 56 

Cry 57 

Nursing 61 

Mixed Feeding 64 

Weaning 65 

The Nipple 70 

The Bottle 75 

Utensils Required for the Home-modification of Cows' Milk 80 

Modification of Cows' Milk 82 

Schedule of Ingredients of Feedings for Babies at Different 

Ages, from Birth to One Year 83 

(ix) 



X CONTENTS. 

PAGE 

Diet Schedule for Children from the First to the Sixth Year of 

Age '. 87 

Twelfth to Fifteenth Month (Five Meals Daily) 87 

Fifteenth to Twentieth Month (Five Meals Daily) 88 

Twentieth to Twenty-fourth Month (Four Meals Daily) . . 89 

Two to Three Years of Age (Three Meals Daily) 90 

Three to Six Years of Age (Three Meals Daily) 91 

Special Conditions Requiring Change in Food Ingredients .... 92 

Preparation of the Feedings in Detail 93 

Care of Feedings in Summer 95 

Pasteurization 96 

Sterilization 98 

Condensed Milk 101 

Lifting Babies 103 

Carrying Babies 107 

Temperature 109 

Emergencies 110 

Eruptive-Fever Chart 116 

Measles 117 

Scarlet Fever 119 

Chicken-pox 120 

Adenoids 121 

Cold in the Head 122 

Diphtheria 123 

Croup 125 

Whooping-cough 126 

Tonsillitis 131 

Mumps 132 

Bronchitis 132 

Pneumonia 133 

Malnutrition (Marasmus) 135 

Rickets 137 

Scurvy 138 

Circumcision 139 

Hives .. . 139 

Eczema 140 

Swollen Glands 141 

Bedwetting 142 



CONTENTS. XI 

PAGE 

Head-lice 143 

Worms 143 

The Nursery 144 

The Wetnurse 145 

Bad Habits 147 

Food Recipes 148 

Index 153 



LIST OF ILLUSTRATIONS. 



Fig. 


1.- 


Fig. 


2.- 


Fig. 


3. 


Fig. 


4, 


Fig. 


5.- 


Fig. 


6.- 


Fig. 


7.- 


Fig. 


8.- 


Fig. 


9.- 


Fig. 


10.- 


Fig. 


11, 


Fig. 


12. 


Fig. 


13. 


Fig. 


14, 


Fig. 


15.- 


Fig. 


16. 


Fig. 


17. 


Fig. 


18.- 


Fig. 


19, 


Fig. 


20, 


Fig. 


21, 


Fig. 


22.- 


Fig. 


23, 


Fig. 


24, 


Fig. 


25.- 


Fig. 


26. 


Fig. 


27, 


Fig. 


28.- 


Fig. 


29, 


Fig. 


30.- 


Fig. 


31, 


Fig. 


32, 



PAGE 

-Rubber Bathtub 1 

-Bath-thermometer 2 

-Manner of Holding Infant during its Bath 3 

-Boric Acid Mouth-wipe 6 

-Torn Flannel Band 10 

-Knit Band 11 

-Long-sleeved Shirt 12 

-Pinning-blanket 13 

-Pinning-blanket Applied 14 

-Long Flannel Skirt 15 

-White Slip 16 

-Worsted Sacque 17 

-Undergarments worn with Short Clothes 18 

-Short Flannel Petticoat 19 

-White Skirt 20 

-White Slip 21 

-Night-shirt 22 

-Night-drawers , , 23 

-Out-of-door Clothing 24 

-Creeping Apron 25 

-Napkin — First Position 26 

-Napkin — Second Position 27 

-Napkin— Third Position 28 

-Napkin— Fourth Position 28 

-Napkin— Fifth Position 29 

-Scales for Weighing the Baby 30 

-Weight-chart 32 

-Front Fontanelle 33 

-Back Fontanelle 34 

-First (Milk) Set of Teeth 39 

-Sleeping Basket 44 

-Position during Stool 48 



(xiii) 



XIV LIST OF ILLUSTRATIONS. 

PAGE 

Fig. 33.— Soapstick 49 

Fig. 34.— Author's Nursery Chair 51 

Fig. 35.— Glass Funnel and Rectal Tube , 53 

Fig. 36.— Position during an Injection 54 

Fig. 37.— Breast-nipple Shield 62 

Fig. 38.— Breast-pump 63 

Fig. 39.— Pap-spoon 68 

Fig. 40.— Small English Nipple 69 

Fig. 41. — Large Conical Nipple 59 

Fig. 42.— Correct Flow 70 

Fig. 43. — Incorrect Flow 71 

Fig. 44. — Various Forms of Rubber Nipples , 72 

Fig. 45. — Various Forms of Rubber Nipples 72 

Fig. 46.— Rubber Nipple Correctly Placed on Nursing-bottle 73 

Fig. 47. — Rubber Nipple Incorrectly Placed on Nursing-bottle 74 

Fig. 48.— Six-ounce Bottle 75 

Fig. 49.— Eight-ounce Bottle 75 

Fig. 50.— Large Flat Nursing-bottle 76 

Fig. 51.— Large Flat Nursing-bottle 76 

Fig. 52. — The Author's Sterilizer, Pasteurizer, and Infants' Nursing- 
bottle Boiler 78 

Fig. 53. — Bottle-guard Fastened in Position by Pins 79 

Fig. 54.— Inverted Bottle-rack 79 

Fig. 55. — Utensils Required for the Home-modification of Cows' Milk.. 81 

Fig. 56. — Correct Position during Feeding 86 

Fig. 57. — Chapin's Dipper 93 

Fig. 58. — Arrangement of Author's Apparatus for Rapidly Cooling the 

Milk after Pasteurization or Sterilization 97 

Fig. 59. — Incorrect (Dangerous). Way to Lift a Baby 103 

Fig. 60.— Correct Way to Lift an Infant 104 

Fig. 61.— Correct Way to Lift a Baby 105 

Fig. 62.— Correct Way to Lift a Baby 106 

Fig. 63.— Correct Way to Carry a Baby 107 

Fig. 64.— Incorrect Way to Carry a Baby , . . 108 

Fig. 65.— Clinical Thermometer 109 

Fig. 66. — Position of Infant during Colic Ill 

Fig. 67.— Method of Holding Child for an Examination of the Throat... 114 
Fig. 68.— Throat Examination of Infants 115 



THE PRACTICAL CARE OF THE BABY. 



BATHING. 



As soon as the umbilical cord falls off, a baby 
should have a bath once a day, preferably in the 
The bath should not be given until an 




Rubber Bathtub. 



hour after a feeding has been completed. The bath 
is usually given between the first and second feed- 
ings. Any form of a tub may be used ; the one that 
seems to me to be the best is illustrated in Fig. 1. 
This tub is made of rubber and the baby may splash 

(i) 



Z THE PRACTICAL CARE OF THE BABY. 

about in it as much as he chooses, with no danger of 
injury to himself by bumping against the sides of the 
tub. Then again, this form of tub may be folded and 
packed in almost any trunk. 

The amount of water used should be such as to 
come up to the level of the baby's navel when he sits 
in the tub. The temperature of the water should be 
98° to 100° F. for a young infant. Gradually lower 
the temperature until the child is one year old, when 
it should be 90° F. Always use a bath-thermometer 
(Fig. 2) to test the temperature of the water. The 
temperature of the room in which the bath is given 
should be 70° F. The child's clothes that are to be 




Fig. 2. — Bath-thermometer. 

put on after the bath should be warm and dry ; they 
should be dried by hanging them over a heater or on 
a rack before a fire. A rubber sheet should be placed 
under the bathtub and the mother or nurse should 
protect her lap with a thick towel. The baby is now 
taken on the lap, undressed (all except diaper), and 
covered with a light blanket. Now take a wash-cloth, 
wet it in the bathtub, and wash baby's face ; now rub 
a little Castile soap on the wash-cloth and wash his 
ears, hands, and then his head ; rinse with clean water 
and rub thoroughly dry. Now take the baby from 
your lap and place him in a sitting position in the tub 
of water. Hold the baby entirely with your left hand 
while he is in the tub, and use the right hand for 



BATHING. 





Fig. 3. — Manner of Holding Infant during its Bath. 



washing him with soap and water (Fig. 3). He 
should remain in the tub about three minutes. 

Lift him out of the tub (see "Lifting Babies") 
and place him on his back on your lap with a soft 



4 THE PRACTICAL CARE OF THE BABY. 

towel under him; under this towel there should be a 
flannel blanket. Roll him from side to side on the 
towel and pat him gently all over. Do not rub him. 
After the excess of water has been dried by the towel, 
pull out the towel, and he now rests on the blanket ; 
roll him up in this blanket, roll him from side to side, 
and pat him once more until dry. Rub him thor- 
oughly with your dry bare hand for half a minute or 
so. Sprinkle dusting-powder on the buttocks, in the 
creases in the thighs, and under the arms ; now put 
on his diaper and then his clothes. In summer it is 
well to give baby a bath in the morning and also a 
second bath just before going to bed, before the even- 
ing feeding; it makes him sleep better. 

Bran Bath. — Make a muslin bag 6 by 6 inches 
in size, and fill it with wheat-bran. Place this bag in 
the bath and squeeze it until the water looks milky; 
now remove the bag from the bath. Place the baby 
in this bath for from ten to twenty minues, bathing 
his back, shoulders, and chest with the branwater. 
This bath is cooling and a good remedy for prickly 
heat, eczema, etc. 



THE EYES. 



When a baby is born its eyes are generally full 
of mucus. This mucus should be cleaned out by 
the attending nurse as follows : The baby should be 
placed on its back, at full length, on the nurse's lap. 
A small piece of absorbent cotton is wet thoroughly 
in a solution of boric acid (a level teaspoonful of pow- 
dered boric acid to a quart of boiled water that has 



THE EYES. 

been allowed to cool) ; let the solution run from the 
cotton into each eye : hold the cotton near the eye, 
but do not try to open the lids. After letting the so- 
lution trickle into the eye, wipe the eye carefully with 
the cotton swab, but do not rub it. Use a fresh piece 
of cotton for each eye. Sometimes a baby is born 
with its eyes full of matter (pus), or a baby who was 
born with perfectly healthy eyes may get them in- 
fected by some unclean substance getting into them 
and setting up a very severe inflammation of either 
one or both eyes. If a baby has matter in its eyes, it 
is best to consult a physician, as often serious de- 
struction of the eyes ensues from not having them 
attended to at once. 

Frequently a baby's eyelids will appear to be 
glued together after the child has been asleep; this 
condition can be best remedied by washing the eyes 
as described above with the boric acid solution, or, 
if the crusts are hard and firm, first wash the eyes with 
lukewarm water and follow it by the boric acid solu- 
tion and then rub a little white vaselin on the lids be- 
fore the baby goes to sleep. 

A baby's eyes should not be exposed to strong 
light until the baby is at least one month old. A baby 
should not sleep with a strong light shining in its face. 
The color of a baby's eyes often changes about the 
seventh week of life to either a lighter or a darker 
shade. 

Foreign bodies in the eyes will be taken up in 
the last section of the book. 



THE PRACTICAL CARE OF THE BABY. 



THE MOUTH. 

The lining membrane of a healthy baby's mouth 
is pink in color, and feels smooth, moist, and warm 
to the examining finger. Along the upper and 
lower jaw sharp ridges can be felt; after the sixth 
month of life these ridges flatten out and the 
gums feel hot as the teeth gradually force their way 
through them. 




Fig. 4. — Boric Acid Mouth-wipe. 



To examine an infant's mouth all that is neces- 
sary in most cases is to take hold of the baby's chin 
with thumb and forefinger and press gently down- 
ward. In older children the handle of a teaspoon will 
be found very efficient in holding down the tongue. 



THE MOUTH. I 

The tongue should be freely movable, and when it 
is bound down too firmly in front it is affected with 
what is known as "tongue-tie." 

To Cleanse Baby's Mouth. — An infant's 
mouth should be cleansed before and after every 
nursing, be it from breast or bottle. A small piece 
of absorbent cotton wet with boric acid solution (a 
teaspoonful of powdered boric acid to a pint of 
water) should be wound around the nurse's little- 
finger tip, as illustrated in Fig. 4; the finger is then 
inserted into the baby's mouth, and the whole inside 
of the cavity gently wiped out. After the baby has 
reached the age of six months the mouth need not be 
cleansed more than once a day. 

Sprue (Thrush) is an inflammation of the lin- 
ing membrane of the mouth; in this condition the 
mouth is covered with small, white spots or streaks ; 
sometimes it affects the sides of the mouth only, or 
it may invade the entire cavity and cover the 
tongue. 

By cleansing the mouth as above directed and 
taking care of the nursing-bottles and nipples as de- 
scribed under "Bottle" and "Nipple" the vast major- 
ity of cases of sprue can be avoided. If this condition 
does occur, persist in washing the mouth as already 
described. 

From the eventful day that the first tooth comes 
until the child can be taught to use a toothbrush his 
teeth should be cleansed with a soft toothbrush. The 
examination of the throat should never be forgotten 
in any case of illness (Figs. 67 and 68). 



THE PRACTICAL CARE OF THE BABY. 



THE SKIN. 

The skin of a healthy newborn baby is red. This 
redness gradually fades as the baby grows older, and 
when the fourth to seventh day is reached the skin 
has a yellow tinge. This yellow color is often mis- 
taken for jaundice, but, if the whites of the eyes re- 
main clear, jaundice can be ruled out. 

After two or three weeks of life the skin attains 
the appearance commonly seen in healthy babies. A 
baby's skin should be rosy when the child is warm, 
and pale and somewhat blue in color when the baby 
is cold. The cheeks and the palms of the hands are 
usually of a deeper shade of red than the rest of the 
body. 

There are certain parts of the body that chafe 
more readily than others, namely: the buttocks and 
the folds in the thighs. This chafing is usually on 
account of the napkins not having been changed 
often enough (see "Napkins"). Sometimes the entire 
body is covered with "prickly-heat" rash; this, of 
course, is seen principally during the hot summer 
months. 

When the weather is cold, the baby's cheeks, 
chin, and wrists are often chapped. The chin is gen- 
erally chapped on account of the bib becoming wet 
from baby's mouth. The bib should be changed as 
soon as it is damp. 

Almond-oil rubbed on the chapped areas will 
generally effect a cure. The chafing on the buttocks 
and thighs is best treated by thorough drying of the 



CLOTHING. 9 

skin after each change of napkins, combined with a 
thorough dusting of the parts with some good dust- 
ing-powder, such as equal parts of pulverized starch 
and stearate of zinc. For the general prickly-heat 
condition, a bran-bath (see "Bathing"), followed by 
thorough drying and an application of a dusting- 
powder, are all that need be done to effect a cure. In 
addition to the above treatment, of course, the baby 
must not be swaddled in hot, thick flannel clothes 
(see ''Clothing"). 

The skin on baby's head is often covered with 
flaky, greasy scales ; this condition is quite common. 
The head should be washed every morning with 
Castile soap and water, after which a little cold cream 
should be applied to the scalp. If the condition per- 
sists, a physician should be consulted. 

The skin carries on a very important function of 
the body, namely : that of excretion, or the throwing 
off of impurities through the pores of the skin by 
means of the sweat. We therefore recognize the 
great necessity of keeping the skin clean. 



CLOTHING. 

LONG CLOTHES SERIES. 

1. First comes a flannel band to protect the 
bowels, and in the very young to protect the newly 
formed navel. This band is called the "torn band," 
because it should be torn from flannel and should 



10 



THE PRACTICAL CARE OF THE BABY. 




Fig. 5.— Torn Flannel Band. 



have no seam or hem. These bands are not generally 
worn after baby reaches the age of three months (see 
Fig. 5). 



CLOTHING. 



11 




Fis- 6. — Knit Band. 



2. After the "torn band" is discarded it is super- 
seded by a woolen knit band, as illustrated in Fig. 
6. (Same in summer.) 



12 



THE PRACTICAL CARE OF THE BABY. 




Fig. 7. — Long-sleeved Shirt. 



3. Knit booties cover the feet (Fig. 6) ; they are 
not a necessity unless baby suffers from cold feet or 
colic. 

4. The long-sleeved woolen knit shirt (Fig. 7) 



CLOTHING. 



13 



^] 



:' 



Fi< 



-Pinnin f?-bl anket. 



comes next. In summer baby should wear merino 
shirts with long sleeves. 

5. Xext comes the pinning-blanket (Fig. 8) ; it 
is made of flannel. Its mode of wearing is illustrated 
in Fig. 9. (Same in summer.) 



14 THE PRACTICAL CARE OF THE BABY. 




Fig. 9. — Pinning-blanket Applied. 



6. Over the pinning-blanket comes the flannel 
petticoat illustrated in Fig. 10 ; the band is made of 
muslin or long cloth. It is made with straps which 



CLOTHING. 



15 




Fig. 10.— Long Flannel Skirt. 



extend over the shoulders so that the weight of the 
petticoat hangs from the shoulders. (Same in sum- 
mer.) 



16 



THE PRACTICAL CARE OF THE BABY. 




Fig. 11.— White Slip. 



7. Over the flannel petticoat comes the white 
muslin dress or slip, as illustrated in Fig. 11. (Same 
in summer.) 



CLOTHING. 



17 




Fig. 12. — Worsted Sacque. 



8. On cold days baby should wear a knit worsted 
sacque, as illustrated in Fig. 12, or a flannel sacque. 



18 THE PRACTICAL CARE OF THE BABY. 




Fig. 13. — Undergarments worn with Short Clothes. 
SHORT CLOTHES SERIES. 

1. Baby is dressed the same as in the "Long 
Clothes Series" (Fig. 7). 

2. Long Cashmere stockings are pinned to the 
napkin and kid shoes are worn, as illustrated in Fig. 



CLOTHING. 



19 





• 4 



Fig. 14.— Short Flannel Petticoat. 

13. Pique shoes are often worn before kid shoes are 
put on. (Same in summer.) 

3. Then comes the flannel petticoat attached to 
a muslin waist, as illustrated in Fig. 14. It buttons 
up the back. (Same in summer.) 



20 THE PRACTICAL CARE OF THE BABY. 







X 



Fig. 15.— White Skirt. 

4. Over the petticoat comes the white muslin 
skirt illustrated in Fig. 15. It also buttons up the 
back, and is made the same as the flannel petticoat. 
(Same in summer.) 

5. Then comes the white muslin dress illustrated 



CLOTHING. 



21 




Fisr. 16.— White SI 



ip. 



in Fig. 10. It also buttons up the back. (Same in 
summer.) 

6. On cold days a sacque similar to the one shown 
in Fig. 12 may be worn, or a light silk kimono is of 
service. 



22 THE PRACTICAL CARE OF THE BABY. 




V 



Fio-. 17. — Night -shirt. 



CLOTHING. 



23 



NIGHT=CLOTHES. 

A baby under one year old generally wears a 
flannel or stockinette "pudding-bag" night-shirt, as 
illustrated in Fig. 17. Baby is undressed all but his 




band and napkin (he should have a night-band as well 
as a day-band) ; the night-shirt is put on, buttoned 
at the front, and the drawstrings drawn and tied. He 



24 THE PRACTICAL CARE OF THE BABY. 




Fig. 19.— Out-of-door Clothing. 



cannot get his legs uncovered when wearing this 
form of night-shirt. A light-weight stockinette night- 
shirt is best for the summer. 

A baby over one year old should wear one-piece 
night-drawers made of Canton flannel or stockinette, 



CLOTHING. 



25 



as illustrated in Fig. 18. These button up the back. 
A lighter weight may be used in summer. 



OUT=OF=DOOR CLOTHES. 

A baby in long clothes should wear the following 
overclothes when he goes out of doors in winter : — 



Long coat. 
Mittens. 



Cap. 

Veil (made of bobbinet). 



The long coat should be lined with all-wool 
flannel. 




Fig. 20. — Creeping Apron. 



A baby in short clothes should wear the fol- 
lowing overclothes when he goes out of doors in 
winter (see Fig. 19) : — 

Coat. Mittens. 

Leggins. Cap. 

Veil (made of bobbinet). 

The veil is worn only on windy days or when 
baby is asleep in a carriage. The leggings are made 
of worsted, and come up to the waist. 



26 THE PRACTICAL CARE OF THE BABY. 



CREEPING APRON. 

A creeping apron is very useful when baby is 
learning to creep, as it does not interfere with the 
free movement of his legs, yet it thoroughly protects 
his clothing (Fig. 20). 






•A. 



Fig. 21. — Napkin — First Position. 

NAPKINS. 

The napkins used by baby during the first month 
of life should be made of cheesecloth. After the first 
month baby's napkins should be made of cotton 
diaper. They should be made oblong and folded 
square, thus : for an infant the diaper should be 36 



NAPKINS. 27 

inches long and 18 inches wide ; when this is folded 
once we have a napkin that is 18 inches square. As 
the baby grows older he will require 20-inch-square 
napkins. Napkins should be folded first square and 
then once again into a triangle, as in Fig. 21. Five 
dozen napkins are usually required. 

To put on a Napkin. — Turn the long edge for 
a distance of two inches and lay the baby upon the 
napkin as shown in Fig. 21 (this photograph for illus- 
trating purposes is taken as though you were look- 




Fig. 22. — Napkin— Second Position. 

ing up through the bottom of a glass bed ; the baby 
is lying on the napkin). Bring the points 1 and 2 and 
the front half of point 3 around in front and hold 
them at X with one hand as shown in Fig. 22. Now 
take points 1 and 2, twist them together, and place 
them down between baby's legs as in Fig. 23. Now 
take the rear half of point 3 and bring it up between 
baby's legs, pinning all together at X as shown in 
Fig. 21. You will notice in Fig. 24 that the top of the 
napkin is still turned over for two inches. This part 



28 



THE PRACTICAL CARE OF THE BABY. 



turned over is now turned up smooth, as is shown in 
Fig. 25, and makes the napkin come up higher in the 
back, doing away with any gap. 

After putting one napkin on the baby it is well 
to put on a second one over it to serve as a protector. 




Fig. 23.— Napkin— Third Position. 

This protector is started the same as Fig. 21 ; the 
points 1 and 2 are pinned at X the same as in Fig. 22, 
but the point 3 is allowed to hang loose. 




Fig. 24. — Napkin — Fourth Position. 

Many mothers and nurses ask the question : 
"How wet shall I let baby's napkins become before 
changing them?" As soon as a baby's napkin is 
damp it must be changed. Napkins should be washed 
once daily. As soon as baby has wet his napkin by 
either urine or stool it should be removed and placed 



NAPKINS. 



29 




Fifth Position. 



at once in a covered napkin-pail ; this pail should not 
be kept in the nursery. 

After a child has attained the age of two years 
the napkins can usually be dispensed with, and 
drawers substituted for them. 



30 THE PRACTICAL CARE OF THE BABY. 



WEIGHT. 

A correct and careful record of baby's weight 
from the time of birth is a thing which many mothers 
and nurses neglect to keep. A knowledge of the 
correct weight of a baby — whether he is losing or 
gaining — is one of the most essential features in the 
care of an infant. Many mothers when asked whether 
baby is losing weight will reply: "I do not know, he 
feels lighter [or heavier] than he did a week ago." 




Fig. 26. — Scales for Weighing the Baby. 

Now, we do not want to know whether an infant 
feels lighter or heavier; what must be known is the 
exact weight of the baby. A correct record — daily 
at first and then weekly — from the time of birth must 
be kept. An infant should be weighed every day at 
the same time of day for the first two weeks of life. 
He should be weighed weekly for the first six or eight 
months, and then every two weeks until one year old. 
During the second year he should be weighed 



WEIGHT. '61 

monthly. The scales must be accurate. The family 
scales with a scoop may be used up to twenty-four 
pounds. A more expensive and delicate scales are 
illustrated by Fig. 26, and weigh up to fifty or sixty 
pounds. 

To Weigh a Baby. — Take a light, soft blanket, 
place it in the scales-pan, and adjust the scales so that 
they balance with the blanket in the pan. Now un- 
dress the baby, taking everything off of him — napkin 
and all. After removing his clothing wrap him up in 
the blanket above referred to and weigh him. The 
weight registered is the exact weight of the baby. 
Always balance the scales each time with the blanket 
in the scales-pan before weighing the baby and always 
weigh the baby as described. A baby is usually 
weighed just before the bath. 

The average weight of a newborn infant is about 
seven pounds. During the first three or four days 
the baby loses in weight, but by the end of from seven 
to ten days he is back again to his birthweight. From 
four to seven ounces each week is a fair (average) 
gain for the first six months ; after that the gain is 
relatively less. A regular gain is the ideal one. If a 
baby is fed entirely upon starchy or prepared foods, a 
great and sudden gain in weight will be the result, 
but that child will not be as strong physically as the 
baby who has had a milk diet and a slow, but steady, 
gain in weight. It is a good plan to provide oneself 
with a weight-chart upon which a correct and in- 
telligible record of baby's weight may be kept. The 
best chart which I have seen for this purpose is the 
one devised by Dr. Walter Lester Carr, and shown in 
Fig. 27. 



32 THE PRACTICAL CARE OF THE BABY. 

Table of Average Weight during First Year of Life. 





BIRTH. 


MONTH. 




1 


2 


3 


4 


5 


6 


7 


8 


9 


10 


11 


12 


Pounds . . 


7 


81 


10J 12§ 13| 


14| 


15| 


16| 


17 


171 


18 


18f 


20 



It will be seen by this table that an infant gains 
more rapidly in weight during the first three months 
of life. During the second year a child gains about 
five pounds. 



GROWTH (LENGTH, HEIGHT). 

The measurement of the length of a newborn 
infant (from top of head to bottom of heel) is about 
twenty inches. Girls are slightly shorter than boys. 
The greatest gain in length is attained during the 
first year (about seven inches). During the second 
year baby grows about three inches more. From the 
end of the second year to the tenth year there is a 
gain in height of about two inches each year. 



DEVELOPMENT. 

The Head. — At birth the average circumference 
of an infant's head is about thirteen and a half inches. 
In the development of the head its diameter keeps 
about the same as that of the chest. 

At the top of the head will be felt a "soft spot," 
through which the brain will be seen to beat or 
pulsate. This spot, or opening, is called the "front 



DEVELOPMENT. 



33 



fontanelle," and indicates the space between the 
four bones which form the top of the skull. This fon- 
tanelle gradually closes as the baby grows, so that 
when he is nineteen months old the fontanelle should 




Fig. 28.— Front Fontanelle. 1 

be about closed. There is another fontanelle called 
the ''back fontanelle," which generally closes when 
baby passes his second month. When the fontanelles 



1 Figs. 28 and 29 are taken from "Practical Obstetrics" (F. A. Davis 
Company, publishers). 



34 



THE PRACTICAL CARE OF THE BABY. 



remain open after baby is two years old a disease 
called "rickets" is to be suspected. 

General Development. — When should baby 
grasp an object placed before it? Anywhere from the 
age of three to four and a half months. 




Fig. 29.— Back Fontanelle. 

When should baby hold his head erect (alone) ? 
About the third to the fourth month. 

When should baby sit up alone, unsupported ? About 
the seventh month he is able to sit up alone for a few 
minutes. 

When should baby creep ? About the eighth 



DEVELOPMENT. 35 

month. Some babies never creep, and cannot get 
from one place to another until they begin to walk. 

When should baby be able to stand (holding on to 
sonic object) ? His legs can generally bear the weight 
of his body about the tenth month, but mothers and 
nurses should not be overzealous in making their 
babies stand, as this often leads to the formation of 
bowlegs. When baby first begins to stand alone 
(holding on to some object), great care should be 
exercised that he does not stand too long each time. 

When should baby be able to stand entirely alone? 
About the eleventh month. 

When should baby walk? A baby that has had no 
severe illness, and that has been properly cared for 
and nourished, should begin to walk when about one 
year old. Oftentimes a baby will walk a few steps, 
fall down, and will not be able to stand up without 
help. At other times a baby will creep, stand up, 
and fall down, but will not be able to walk. Do not 
urge a baby to walk. He will walk when he gets 
ready to do so. Many a mother is so anxious to see 
her baby walk that she really does her child an un- 
intentional injury by urging him to walk, oftentimes 
causing bowlegs. You have probably heard the fol- 
lowing remark by a mother: "What! Doesn't your 
baby walk yet? My baby walked alone when he was 
nine months old !" (If you could see her baby's bow- 
legs, you would see that he did.) Let a baby have all 
the room he wants in which to practice walking, let 
him alone, and he will walk when Nature says that he 
is ready to walk. 

When does a baby see? An infant will notice ob- 
jects (especially a bright light), at the end of the first 



36 THE PRACTICAL CARE OF THE BABY. 

I 

week, but for him actually to see (the way we see) and 
to distinguish one object from another he must wait 
until he is from three to four months old. 

When does baby hear? For a day or so after baby 
is born he is totally deaf. This deafness gradually 
disappears, and in a few weeks he is able to hear ex- 
ceedingly well. Noises which seem to us very in- 
significant sound very loud to an infant. 

When does baby taste ? From birth. He also 
knows whether his bottle is too hot or too cold. 

When should baby begin to talk? At about one 
year he says "mamma" and "papa." During the sec- 
ond year he learns the names of animals, persons, and 
objects, and may in some instances put two words to- 
gether, such as "mamma dawn" (meaning "mamma 
gone"). Baby usually learns the names of things by 
the sound they make ; for instance, a dog is a "bow- 
wow" or a "boo," a cat is a "mew," a bell is a "ding- 
ding," a cow is a "moo," a clock is a "ticktock," etc. 
The hard consonants, such as g and k, are very difficult 
for baby to pronounce ; w and r are also difficult ; 
therefore if baby wishes to say "I want a drink of 
water" he says: "I awnt a dink awter." 

Babies usually find it very hard to find a name for 
grandma and grandpa, so say "nana" or "donna." 
Mothers and nurses should not begin to talk "baby- 
talk" to their babies, for if they do a child is obliged 
to learn the meaning of a word in "baby-talk" and 
then later learn another meaning for it in English. A 
fond mother will say to her baby : "Wat oo ooin, oo 
ear ittle sing?" (what are you doing, you dear little 
thing?) Now, this is certainly not the way to teach 
children to speak correctly. I have in mind a girl 



DEVELOPMENT. 37 

who is now nearly twenty years old, and she has be- 
come so addicted to "baby-talk" that she cannot drop 
it. If a baby is brought up in a large, cheerful family, 
that baby will talk sooner than the baby that is reared 
in a small, quiet family that never thinks that a baby 
should be spoken to or have any toys with which to 
play. A baby need not have expensive toys, but he 
should be supplied with blocks, pieces of wood, 
smooth stones, rag dolls, paper magazines, etc. He 
should be allowed to play in the dirt, dig in the sand, 
— never mind if he does get his hands, face, and dress 
dirty ; let him have a good time. 

Treat a baby as though he were a human being. 
When he cries, do not laugh at him — it only teases 
him. When he needs sympathy, sympathize with him 
(but not unnecessarily) ; yet if he falls and slightly 
bumps his head, do not rush over to him and make a 
great time over him, calling him all the pet names 
that you know and showering him with kisses — you 
will make a "baby" of him all his life. Do not scold 
him for falling and hurting himself; that will make 
him believe that he has done wrong, which he has 
not. If baby falls and bumps his head, say to him in 
a cheery voice : "Well ! Well ! What do you do 
when you fall down — get up again?" or "Stand up 
and try it again." A favorite of mine, which I have 
found to work in almost every case, of "bump," is to 
go to where he has fallen and with him examine the 
piece of furniture (or floor) that he hit and see if baby 
hurt it any ; he usually will become so interested that 
he will forget all about his own injury. Baby should 
never be told that it was the "naughty" door that hit 
him, and to go and spank it; this is placing a wrong 



38 THE PRACTICAL CARE OF THE BABY. 

idea in his head which might work great injury in 
after years. Never deceive a baby, for he will never 
forget it. 

Do not say to him : "Oh, this will not hurt you !" 
and then, after he has given you his confidence, abuse 
it by hurting him. If you are going to hurt a baby, 
tell him so; if you are not going to hurt him, tell him 
so. A baby is like a horse : once you deceive him, 
he is always your enemy. Why is it that ninety-nine 
out of every hundred babies are afraid of a doctor? 
Tell them a doctor is coming and they will cry ; tell 
them a wagon is coming and they seem to enjoy it! 
The ideas that are developed in a child's mind are 
truly wonderful ! As a prominent photographer has 
said : — 

"You cannot make a specialty of children ; they 
must make a specialty of YOU." 



DENTITION. 



39 



DENTITION (TEETHING). 

Baby's first set (milk-set) of teeth consists of 
twenty teeth. The first teeth to come through are 
the two lower central incisors, which generally ap- 
pear from the fifth to the ninth month. Then come 




si 

4 

5 



Lower Incisors — fifth to ninth month. 
Upper Incisors — eighth to twelfth month. 

Lateral Incisors and First Molars — twelfth to eighteenth month. 
Stomach and Eye Teeth— eighteenth to twenty-fourth month. 
Second Molars— twenty-fourth to thirtieth month. 
Fig. 30.— First (Milk) Set of Teeth. 1 



the four upper central incisors, which appear from 
the eighth to the twelfth month. The next to come 
through are the two remaining lower incisors and the 



1 The outline of this illustration is taken from Starr's "Hygiene of 
the Nursery.'' 



THE PRACTICAL CARE OF THE BABY. 



first molars (two of the latter in both upper and lower 
jaws); this group appears from the twelfth to the 
eighteenth month. In some babies the two incisors 
come through before the first molars ; but the usual 
rule is for the first molars to appear before the two 
lateral incisors. Then come the four canine teeth, 
the two upper ones being commonly known as "eye" 
teeth and the two lower ones as the "stomach" teeth ; 
they show themselves when baby is from eighteen to 
twenty-four months old. Last of all come the four 
second molars (two in each jaw), which appear from 
the twenty-fourth to the thirtieth month. 

In the diagram (Fig. 30) will be seen the posi- 
tion, name, and month of appearance of the first set 
of teeth as they usually appear in a healthy baby. If 
the baby has had any severe illness or has not been 
nourished properly, all sorts of variations from the 
normal are liable to be seen. In healthy babies there 
may be certain departures from the ordinary rule in 
the appearance of teeth. Babies fed from the bottle 
usually get their teeth later than breast-fed babies. 

Signs of Teething. — Baby is fretful and pee- 
vish. He continually puts his fingers in his mouth. 
Hands and head feel hot (may have fever of from 
one to two degrees). He is restless when asleep and 
frequently will cry out during his sleep. A great in- 
crease of saliva is seen, and this continual drooling 
makes it necessary to change his bib frequently. His 
mouth is hot and his gums are red and swollen. 

Management of Teething. — When baby 
shows the first symptoms of a new tooth appearing, 
his diet should be lessened in quality (not quantity). 
If he is taking a milk mixture, the ingredients of milk 



DENTITION. 41 

and cream (especially the milk) should be cut down 
by at least one-fourth, and in some instances of great 
suffering-, fever, etc., to one-half the regular quantity. 
This is applicable, of course, only to a bottle-fed baby. 
If he is a breast-fed baby, he is not liable to have many 
severe teething symptoms. Everything pertaining 
to the baby's food should be kept scrupulously clean, 
as it is not teething in itself that causes trouble, but 
the fact that the baby, being in a lowered state of 
vitality owing to pain, fever, etc., is much more liable 
to respond to the injurious effect of dirty nipples, bot- 
tles, and sour milk. I cannot emphasize this point too 
strongly; the milk must be perfectly fresh and all the 
utensils used in making baby's feedings must be clean. 

Frequent sips of cool water are very comforting 
to a baby whose mouth is hot and dry. Gently rub- 
bing the gums with one's bare finger is soothing to 
some babies (and irritable to others). If the tooth 
is almost through, as evidenced by swollen gums and 
the fact that you can feel with your finger a hard ob- 
ject (the tooth) directly under the gum, this tooth 
may be "rubbed through." 

Hozu do you rub a tooth through ? Take a towel 
and place one thickness over your first finger; rub 
the baby's gum with this directly over the tooth ; use 
quite a little pressure. The gum having bled a little, 
the white tooth will be seen. Do not rub all of the 
tooth through ; as soon as you have broken the sur- 
face of the gum the tooth will gradually force its way 
through without any more help. When the gums are 
badly swollen or baby has any serious symptoms, — 
such as vomiting, green stools, diarrhoea, convul- 
sions, etc., — consult your physician at once. 



42 THE PRACTICAL CARE OF THE BABY. 



AIRING. 

A baby born in a spring month (March, April, 
or May) should first be taken out of doors when he 
is one month old. His first airing should be for half 
an hour. The length of time of airing should be in- 
creased, as baby grows older, to two or three hours. 

A baby born in a summer month (June, July, 
or August) should first be taken out of doors when 
he is ten days old. His first airing should be for one 
hour and gradually increased, as he grows older, until 
he remains out of doors for nearly the entire day. 

A baby born in a fall month (September, Oc- 
tober, or November) should first be taken out of 
doors when he is one month old. His first airing 
should be for half an hour, and it should be gradually 
increased, as he grows older, to two or three hours. 

A baby born in a winter month (December, 
January, or February) should first go out of doors 
when he is two months old — on pleasant days when 
the thermometer is not lower than 32° F. He should 
be sheltered from both sun and wind. His first 
airing should be for from fifteen minutes to half an 
hour, and should gradually be lengthened, as he 
grows older, to one hour or an hour and a half. He 
may be aired indoors when one month old by placing 
him in his carriage, clothed as for outdoors, and 
opening the windows. Allow him to be aired in this 
way for half an hour. 

It is best always to air baby in his carriage. If 
he goes to sleep out of doors, let him sleep; it will not 



EXERCISE. 43 

hurt him. Baby's eyes should always be protected 
from the sun and strong light by the use of a parasol. 

A baby up to one year old should have his face 
protected in the winter months by a thin veil with no 
spots in it. A baby in summer should not go out- 
doors until one hour after his bath; and in winter 
not until two hours after he has been bathed. During 
the summer a baby should live out of doors (eat and 
sleep) all day long, except during excessive heat. 

The best time to air a baby is, in 

Spring 9 a.m to 4 p.m. 

Summer 7 a.m to 6 p.m. 

Fall n 9 a.m to 4 p.m. 

Winter 9 a.m to 3 p.m. 

On very hot days baby should be taken into the 
house during the hottest part of the day (say from 11 
a.m. to 2 p.m.). On rainy or stormy days baby must 
have his airing indoors. 



EXERCISE. 



Baby should have exercise from birth. The 
clothing should not be so tight as to restrict free mo- 
tion of arms or legs. When baby is wearing long 
clothes he should be allowed once a day to lie upon 
the bed for half an hour, having on nothing but his 
band and napkin ; let him kick his legs and throw his 
arms to his heart's content. When baby gets into 
short clothes a comforter should be spread on the 
floor upon which he can roll and tumble. His lungs 
are exercised by crying. 



44 



THE PRACTICAL CARE OF THE BABY. 



SLEEP. 

A newborn baby sleeps nearly all the time. For 
at least three weeks after baby is born he should not 
sleep in the same room with his mother ; he will cry 
and break his mother's rest, which is so essential to 
her rapid convalescence. Where should he sleep? 
One of the best beds for a young infant is a large 
basket (Fig. 31). In the bottom of this basket there 
should be a hair mattress over which is spread a 




Fig. 31. — Sleeping Basket. 



quilted pad. The baby is placed upon this pad with 
his head very slightly higher than his feet. One of the 
best features of this basket-bed is the fact that the 
baby may be moved at pleasure whether asleep or 
awake without disturbing him in the least. He can 
be brought from his mother's room into another 
room when a day or so old, to show him to admiring 
friends, or he can be taken out of the room at night 
as soon as he commences to cry. It is the most con- 



SLEEP. 45 

venient bed that I have ever seen. After he is a few 
weeks old and knows how to "behave" himself at 
night, he may sleep in his mother's room or in the 
nursery in a crib. A baby should never sleep with 
anybody, for the most careful mother is apt in her 
sleep to roll on her baby and smother him; then, 
again, baby does not get enough air when sleeping 
with a person. He should always sleep alone. 

Cribs. — Cribs are of so many shapes and sizes 
that it will be impossible to enumerate them all. Bas- 
sinets are very pretty for baby to sleep in and will do 
for him until he is three to six months old, and then, 
if he is at all given to waking up early and exploring 
his bed, there is a grave chance of his falling out and 
being injured. The best bed for baby after he has 
grown out of his "basket-bed" is a white-enameled 
iron crib with sides that may be lowered at will. 
Buy a crib that baby can use until he is three or four 
years old, unless you wish to purchase a new one 
each year. Some babies are so lively when awaken- 
ing that it becomes necessary to build a wooden 
fence about the crib in order to make the sides higher 
and prevent baby from falling over the railings when 
he stands up. The best position for baby's crib is 
beside his mother's bed. He may sleep beside his 
mother until he is a year and a half old, when his 
crib had best be placed in a protected corner of the 
room occupied by his mother or in the nursery. 
Canopied cribs look pretty, but I am not in favor of 
them unless the baby has to be protected from a 
draught from fireplace or leaky window. 

To Make Baby's Bed. — He should sleep on a 
hair mattress, He should have a small hair pillow; 



46 THE PRACTICAL CARE OF THE BABY. 

some babies will not use a pillow, so if they do not 
like it let them go without it. Over the mattress 
spread a small rubber sheet ; this sheet should simply 
be large enough to protect the mattress which comes 
directly under the baby's buttocks. Over the rubber 
sheet comes a large quilted pad covering the entire 
mattress. Over this quilted pad comes a cotton 
sheet. Upon this cotton sheet is placed a small 
quilted pad. The baby is placed upon this second 
quilted pad ; if he wets his napkin while in bed, this 
second quilted pad is removed and the remainder of 
the bed is kept dry. A second cotton sheet is spread 
over the baby, and over this sheet comes the flannel 
blanket. Baby should be provided with two thin and 
two thick flannel blankets. No rule can be laid down 
regarding the proper covering of a baby. Generally 
babies are covered up too warmly when asleep. If his 
wrists, arms, and feet feel warm, he is considered as 
being covered sufficiently. A baby should never be 
covered with anything more than one sheet and a 
sufficient number of blankets, when sleeping in his 
crib. (For the proper night-clothing see "Cloth- 
ing.") 

Never rock a well baby to sleep ; if he is ill or has 
pain, sympathize with him and rock him, but a well 
baby should be taught from birth that when he is 
placed in his crib that he is to go to sleep! A breast-fed 
baby should be nursed just before going to bed at 
night. A bottle-fed baby can have his bottle after he 
gets in his crib ; before his evening meal is finished 
he is covered up in bed, the lights turned OUT, and 
he is to be made to understand that he is to go to 
sleep. If he is a very young infant, the nurse should 



BOWELS. 47 

be near at hand to see that he does not roll over on 
his face and smother ; but after he reaches the age of 
six months, he may be left to himself ; the mother or 
nurse should be near enough to hear if he is restless 
or "fussing." 

What should be clone if, as soon as baby is put 
to bed and finds himself alone, he commences to cry? 
He is to cry it out until he goes to sleep, if nothing is 
bothering him. (See chapter on "Cry.") 

Never romp or play hard with a baby just before 
he goes to bed. Fond fathers are prone to come 
home at night, and, not having seen their babies all 
day, they romp with them and get them all stirred up 
and nervous when night comes — just the time, above 
all others, when their little nervous systems should 
be at rest. Ntght-terrors (bad dreams) of childhood 
are usually due to indigestion. In regard to baby 
sleeping out of doors see chapter on "Airing." A 
child should have a nap during the day until he is four 
years old. The best time for baby's day nap is directly 
after the feeding in the middle of the forenoon, about 
ten o'clock. Never awake a well baby; allow him 
to awake himself. Some children require more sleep 
than others. 



BOWELS. 



A baby should move his bowels twice a day 
(morning and evening) until he is two years old. His 
bowels should move at a regular hour every morning 
and also at a regular hour every evening from birth. 
Mothers will say : "My baby will not move his bowels 
at a certain hour!" MAKE him do it. Babies are 



48 



THE PRACTICAL CARE OF THE BABY. 



creatures of habit, and, if a regular time for moving 
their bowels is established twice a day from the day 
they are born, they will soon fall into the habit and 




Fig. 32. — Position During Stool. 



carry it on for the remainder of their lives. In a 
young infant the best time for the morning move- 
ment is just before the bath. 



BOWELS. 49 

A young infant should not move his bowels im- 
mediately after his feeding, for, if he does, he is liable 
to regurgitate the feeding. After a baby is one year 
old he may move his bowels after his first morning 
feeding without fear of regurgitation. The best time 
for the evening movement is just before baby goes to 
bed, immediately preceding his evening feeding. 

In what position should baby be placed when moving 
his bozvels? He should be placed on his back on the 
nurse's lap and his feet elevated as in Fig. 32. A 
rubber sheet should be placed over the nurse's lap 
and a napkin should be placed under the baby's but- 
tocks. If he does not move his bowels in a minute or 




Fig. 33.— Soapstick. 

so, the nurse should place a little clean vaselin on the 
tip of her clean finger and slightly irritate baby's rec- 
tum. Keep the finger there for a few minutes, being 
careful that the fingernail does not injure the sur- 
rounding parts. This is often all that is necessary to 
bring about a movement. Let the baby know that he 
is there to move his bowels! Tell him so. 

If after five minutes of continued trying he ac- 
complishes nothing, we must resort to the use of the 
soapstick. Take a cake of white Castile soap, cut it 
into minute bars, and whittle each little bar clown to 
the form of Fig. 33. Make a dozen or so of these 
sticks, as you will probably need them. Take one 
of these soapsticks, smear vaselin upon the end of 



50 THE PRACTICAL CARE OF THE BABY. 

it, and introduce it into baby's rectum ; keep it there 
until the bowel matter comes down and pushes it out. 

You may be compelled to have several of these 
soapstick seances with your baby before he will under- 
stand what is expected of him. In some cases baby 
will require the use of the soapstick for a long time ; 
if he does, it will not hurt him. The soapstick is far 
superior to drugs or suppositories. After a soapstick 
has been used, it should be washed in water and kept 
for the next time ; if it wears down too small, discard 
it and use a new one. 

When should baby be taught to sit on his nursery- 
chair? After he is six months old. Oftentimes he 
will not know what is expected of him when placed 
in this new position to move his bowels, but a little 
of the same persuasion practiced on him with your 
vaselined finger or soapstick will soon accomplish the 
desired result. The modern nursery-chair, to my 
mind, is wanting in a very necessary feature, viz. : 
when baby is sitting upon the chair there is no way 
in which to get your finger or soapstick anywhere 
near his rectum, unless he sits on the nurse's hand 
while she holds the soapstick in position ; this is most 
uncomfortable for both nurse and baby. The chair 
designed by the author (Fig. 34) obviates all such 
bother, as there is a door cut in the side of the chair 
through which the nurse's hand has full access in the 
cases where the soapstick becomes necessary. 

What is the appearance of a healthy stool? At birth 
and for a few days afterward baby's stools are dark 
colored; he is passing a substance known as "me- 
conium," which all healthy babies pass. The napkin 
will often have to be changed from four to seven 



BOWELS. 



51 



times a day for the first few days, until this meconium 
has entirely disappeared ; then the stools should have 
the appearance and consistency of light-yellow mus- 
tard. 




Fig. 34. — Author's Nursery-chair. 

Variations from the Normal, Healthy 
Stool. — Green. — Indigestion. Inflammation of the 
bowels. 

White or Yellow Curds Mixed with Bowel Sub- 
stance. — Milk is too rich in proteids (proteid is the 
curd of the milk) and should be diluted more. 



52 THE PRACTICAL CARE OF THE BABY. 

Black or Brown. — Beef-juice or medicine may 
cause this color; they may become black from con- 
taining blood. 

White, Pasty, Claylike, with a Foul Odor. — 
Chronic indigestion. 

CONSTIPATION. 

Constipation is more frequently seen in bottle- 
fed babies than in breast-fed babies; this is occa- 
sioned by generally using a milk mixture that is too 
rich in proteids (curd of the milk). In older children 
constipation is often caused by giving the child fresh 
bread, potatoes, and other starchy food. Not having 
a regular time to move the bowels will cause consti- 
pation. Not having sufficient exercise is a predispos- 
ing cause. In breast-fed babies constipation is usu- 
ally caused by the mother's diet being faulty (see 
"Diet of Nursing Mother"). 

What should be the treatment of constipation? Try 
to regulate it by a proper diet. If in a young infant, 
dilute the feeding one-fifth with water and add a little 
more cream or use a weaker feeding formula. It is 
often of service in constipated bottle-fed babies to 
use oatmeal-water instead of plain boiled water in 
making the feedings. Have a regular time to move 
the bowels and try the vaselined finger or soapstick 
mentioned earlier in this chapter. The temporary 
use of a glycerin suppository each night and morn- 
ing or an injection or two of warm, soapy water 
may often suffice to remove the accumulation of 
faeces from the rectum and relieve the constipa- 
tion. If the stools are hard, the . introduction of 
an ounce of sweet oil into the rectum by means 



BOWELS. 53 

of a rubber tube and funnel is often very effi- 
cacious in removing the hard concretions which form. 
Fig. 35 shows the tube and funnel. The funnel is of 
glass and may be purchased at any drugstore. The 
tube is of soft rubber, and is called a small rectal tube. 
The funnel and tube should be boiled in water before 
using them. The tube is pushed on over the end of 




Fig. 35. — Glass Funnel and Rectal Tube. 

the funnel for half an inch. The tip of the tube is 
slightly vaselined and pushed very gently into the 
baby's rectum for a distance of three inches. Baby 
should lie on the nurse's lap, on his back, and the 
nurse should elevate his legs as in Fig. 32. The 
sweet oil slightly warmed is slowly poured into the 
funnel. If the oil refuses to run, move the tube 



54 



THE PRACTICAL CARE OF THE BABY. 








§ i 







i ' ■ 






9 If 



? 



Fig. 36. — Position during an Injection. 

slightly in and out of the rectum, for the eye of the 
tube may possibly be clogged. After all the oil has 
run into the rectum, gently withdraw the tube. After 
the tube has been withdrawn, pinch the buttocks 



BOWELS. 55 

together and hold it for a few moments so that no oil 
can escape. In from half an hour to three hours (in 
some cases longer) baby will have a soft stool. 

To Give an Injection. — Lay the child on your 
lap protected by a rubber sheet and raise his feet as 
illustrated in Fig. 36. A fountain syringe, consisting 
of a one-quart rubber bag, a long rubber connecting 
pipe, and a small rubber rectal tube, form the best 
syringe. The bag is filled with warm, soapy water. 
The rectal tube is connected to the long rubber pipe 
by means of a small piece of glass tubing. The rectal 
tube is vaselined and the tip of it is inserted into 
baby's rectum. The water is now allowed to run 
from the bag and the rectal tube is pushed into the 
rectum for about five inches. The fountain-bag 
should hang four feet above the baby. Allow all the 
water to run into the baby's bowel; this water will 
come out again through the bowel along the side of 
the rectal tube and will wash out the accumulation 
of faeces contained in the rectum. 

In Older Children the drinking of hot water 
(a glass before breakfast) or the juice of an orange 
before breakfast and scraped apple, fruit in season, 
stewed prunes, stewed pears, or baked apples eaten 
during the day will often correct the constipation. 
Let the child get plenty of exercise (see "Exercise"). 
Massaging the bowels with the warmed hand just be- 
fore baby goes to stool will often assist in relieving 
constipation ; rub the skin over the bowels with the 
tips of your fingers, using gentle pressure. 

A fallacy among many mothers and nurses is to 
give castor-oil whenever baby becomes constipated ; 
castor-oil should not be given repeatedly. A single 



RACTICAL CARE OF THE BABY. 



good dose of castor-oil may be of benefit in cases 
where baby has colic, diarrhoea, or fever, but to use it 
repeatedly is a great mistake. Drugs should not be 
used to relieve constipation unless prescribed by a 
physician. 

DIARRHCEA. 

Diarrhoea may be caused by contaminated food 
or water, sour milk, too much fat (cream) in the feed- 
ings, too much sugar in the feedings, partly cooked 
food, and unripe fruit. Various diseases may be 
ushered in by diarrhoea. In a breast-fed baby it 
is sometimes caused by the mother having received 
bad news or having had a nervous shock of any kind. 

When baby has diarrhoea it is wise to consult 
your physician, as a little judicious treatment at the 
commencement of any form of diarrhoea may often 
abort a severe illness. Diarrhoea is seen more often 
in summer than in winter, because the hot weather is 
very conducive to the contamination of milk, which 
forms nearly all of baby's food. The "summer diar- 
rhoea," which all mothers so much dread, is usually 
occasioned by not having exercised proper care re- 
garding baby's feedings; the bottles or nipples were 
not washed and kept perfectly clean, the drinking 
water was not boiled, the milk had become sour, or 
possibly before the milk reached the mother's 
hands it had become infected by being placed in a 
dirty pail in the farmyard. Bottle-fed babies are 
much more liable to attacks of diarrhoea than are 
breast-fed babies. In older children the eating of 
unripe fruit or of half-cooked food will cause diar- 
rhoea. In breast-fed babies diarrhoea is often caused 



CRY. 57 

by the mother having eaten something (or taken 
medicine) that caused diarrhoea, the laxative effect of 
which is carried by the mother's milk to the child. 
Teething by itself does not cause diarrhoea or 
"summer complaint." When a baby is getting his 
teeth, especially his eye teeth, stomach teeth, and 
molars, he is in such a condition that the least 
injudicious feeding, the least contamination of the 
milk, will cause an attack of diarrhoea ; hence the so- 
much-feared "second summer." If baby is suddenly 
taken with a diarrhoea (possibly green stools), has 
fever, and is greatly depressed, you must stop all 
milk, give him a dose of castor-oil (20 drops to a 
young infant; 1 teaspoonful to a child six months 
old), and send for your physician. Give baby no 
food but barley-water (see "Barley-water"). Be very 
careful that baby's mouth is washed (see "Mouth") 
before and after each feeding until he is six months 
old ; then wash it morning and night ; this will often 
prevent diarrhoea. The mildest cases of diarrhoea 
often prove rapidly fatal; always consult the physi- 
cian when the first symptoms of diarrhoea manifest 
themselves. 



CRY. 

As soon as baby is born it becomes the sad, 
but necessary, duty of the attending physician to 
make that infant cry! Why? Because a good crying 
spell clears the mucus from baby's throat and wind- 
pipe ; expands the lungs, which have never breathed 
before ; and also sends the blood to the extremities. 

If when an infant is a few hours old, and has had 



58 THE PRACTICAL CARE OF THE BABY. 

his first crying spell, the nurse or attendant notices 
that the child keeps extremely quiet, does not cry, 
and upon feeling of the body finds that his hands or 
feet feel cold or that he does not seem to be breathing 
regularly, he should be made to cry again. 

Hoiv should baby be made to cry? Lay the baby 
on his stomach on the palm of your left hand and 
spank him (gently at first) on his buttocks with the 
palm of your right hand. Slap him from three to ten 
times. He will in almost every instance begin to cry. 
You will now notice that after this crying spell his 
feet and hands are quite warm and he is breathing 
much better. 

It is a very hard thing for mothers to see their 
offspring so early chastised in this manner, but they 
will soon realize that it was done for the good of the 
baby. 

What conditions cause a baby to cry? They are as 
follows : — 

1. He is hungry. 7. He is tired of lying in one po- 

2. He is thirsty. sition. 

3. He is in pain. 8. He is frightened. 

4. He wants attention. 9. He is exhausted. 

5. He is sleepy. 10. He is crying from temper. 

6. His napkins are wet. 11. His clothing is uncomfortable. 

1. He is Hungry. — The cry of hunger is a con- 
tinuous one, accompanied by sucking of the fingers. 
The cry stops immediately when baby gets his food. 

2. He is Thirsty. — Cry is generally continuous 
and stops when baby is given a drink of water. 

3. He is in Pain. — If in pain from a pin pricking 
him, the cry is sharp and continuous. If from colic, 
the cry may be spasmodic, accompanied by drawing 



CRY. 59 

up of the knees and turning the thumbs inside the 
closed fingers. Earache and teething are frequent 
causes of crying from pain. 

4. He Wants Attention, — Baby very soon finds 
out that he likes attention. When he is laid down 
alone or the mother or nurse goes out of his sight, he 
sets up a cry for renewed attention; he wants to be 
cuddled or rocked. If he does not get just what he 
wants, he will cry ! His cry will immediately stop 
when he is taken up, held, or rocked. Oftentimes as 
soon as he sees his mother coming to him his cries 
cease; in other words, he is rapidly becoming a 
''spoiled" baby. One cannot begin "too young" to 
train a baby. We often hear the remark made by 
some dear old grandma or loving mother : "Oh ! he 
will grow out of it," or "Wait until he grows a little 
older and understands what you say to him." If you 
do wait a few months, you are lost ! Begin when a 
baby is bom to make him understand that you mean 
what you say ; you are the one to be obeyed ; it is for 
your child's good. We now come to the treatment, 
as it were, for a baby who crys simply because he 
wants attention, which is : Baby must cry it out. 

One of the hardest trials of a young mother's 
life is to hear her baby cry and not "give in" to him. 
After baby has cried it out two or three times he soon 
finds that, no matter how hard he cries, no one seems 
to care, so he stops crying. Oftentimes one good 
''cry it out" will be all that is necessary. If a baby is 
not born with a rupture and wears a good, firm, sup- 
porting flannel band, there is absolutely no danger 
of crying causing a rupture. 

5. He is Sleepy. — A baby will often fight against 



CO THE PRACTICAL CARE OF THE BABY. 

going to sleep. He will cry a few good cries, which 
finally become weaker, and with a little moan or a 
long sigh baby is asleep. 

6. His Napkins are Wet. — When baby cries, al- 
ways examine the napkins, and change them if they 
are at all damp. 

7. He is Tired of Lying in One Position. — In very 
young or weak babies who are unable to change their 
position themselves, we find that changing their posi- 
tion — laying them on their other side — often stops 
their crying. 

8. He is Frightened. — Babies from six months to 
two years old will often wake suddenly, find them- 
selves in a dark room, or after a bad dream, and cry 
out in a shrieking voice. They should be taken up or 
talked to in a soothing way, and placed back in bed 
again. This generally suffices. 

9. He is Exhausted. — Crying from this cause is 
usually a low, moaning cry, and is seen in very ill or 
weak babies. 

10. He is Crying from Temper. — This form of cry- 
ing is seen in older children ; they cry loudly, swing- 
ing their arms and kicking their feet. Tears are 
supposed to be seen in babies who are crying from 
pain, but I have seen a baby cry real tears from noth- 
ing but temper. Tears do not usually show them- 
selves until after the baby is one and a half to three 
months old. 

11. His Clothing is Uncomfortable. — Often baby's 
band or napkin becomes wrinkled and hurts him. 
Take him up, smooth his clothes, and he will stop 
crying if the cry was occasioned by uncomfortable 
clothing 1 . 



NURSING. 61 

A young infant cries quite a little ; it is healthful 
for him to cry and is a part of his daily exercise. If a 
baby cries, go over the list of causes that are above 
enumerated, and if he is not crying from any cause 
except the "wants attention" cause, let him cry it out. 



NURSING. 



The milk does not generally show itself in the 
mother's breasts until the third to the fifth day after 
the baby is born. A substance known as colostrum 
forms in the breasts; this colostrum is thinner than 
breast-milk and has a laxative effect upon the baby; 
this laxative effect is just what we desire to clean out 
the baby's intestines of the dark-brown meconium 
contained in them. Baby should be nursed about 
every four hours for the first three days. If he cries 
from thirst, give him a drink of warm water (that has 
been boiled) with a little granulated sugar in the 
water: 1 / 4 teaspoonful to 8 ounces of water. 

After the third day, when the milk has come into 
the breasts, baby should be nursed every two hours 
from 6 a.m. to 10 p.m. He should have one night- 
feeding at 2 a.m. As he grows older the frequency of 
feeding should be the same as for a bottle-fed baby. 
A baby should nurse at the breast for from fifteen to 
twenty minutes. If the milk is very abundant, let him 
nurse from but one breast ; if the milk is not very 
abundant, he may nurse from both breasts. 

• The breast-nipples and baby's mouth should be 
washed with a saturated solution of boric acid before 



62 THE PRACTICAL CARE OF THE BABY. 

and after each feeding (see "Mouth"). After each 
nursing it is a good plan to spread a piece of sur- 
geon's lint with vaselin and place this lint pad over 
the breast-nipple to keep the nipple soft and prevent 
its cracking. When a young infant is nursing, be sure 
that his nose is not buried in the breast, thus prevent- 
ing his having a good meal and also causing colic. If 
a breast swells and becomes hard, rub it gently toward 
the nipple with the bare fingertips ; cloths wrung out 
in hot water and frequently applied will often relieve 
this condition of "caked breast." When the breasts 




Fig. 37.— Breast-nipple Shield. 

are swollen and hard, summon your physician, as by 
his care you may avoid an abscess. 

A great deal of perseverence is required with 
some babies to get them to take the breast-nipple. If 
the breast-nipple is short or sunken, a breast-shield 
(Fig. 37) is required. This shield is put on over the 
breast-nipple, while baby sucks on the rubber nipple ; 
care should be exercised that no air gets under the 
breast-shield. After nursing the shield is washed in 
water and kept in a solution of boric acid (see "Nip- 
ples"). 



NURSING. 63 

In some instances baby will not nurse from a 
breast-shield at first, and it becomes necessary to 
pump out the mother's breasts every two hours with 
a breast-pump. Fig. 38, putting the breast-milk thus 
obtained in a bottle and feeding the baby from a bot- 
tle and nipple ; this procedure should not be long 
continued. 

A nursing mother should not be subjected to 
fright ; fear, anger, or passion also will cause diges- 
tive disturbances in her baby. A nursing mother 
should eat good, nourishing food, such as meat, milk, 




Ficr. 38.— Breast 



pump. 



eggs, cocoa, etc. She should take a glass of milk, 
soup, or cocoa at 10 a.m. and at 4= p.m. She should 
be out in the open air all she can, and also kept free 
from worry. She should take exercise, preferably 
in the open air, but not enough greatly to fatigue her. 
She should abstain from tea and coffee and from all 
alcoholic beverages unless prescribed by her physi- 
cian. Her bowels should move once a day. In other 
words, she should lead a calm, steady, and happy life. 
If baby loses weight or his weight remains sta- 
tionary for a week or two, if he is peevish and fretful, 



64 THE PRACTICAL CARE OF THE BABY. 

cries after being nursed, sleeps poorly, or sucks his 
hands, these conditions are all symptoms of inade- 
quate feeding. The breast-milk is either insufficient 
in quantity or poor in quality. If these symptoms 
occur, consult your physician; he will tell you 
whether a change in diet will bring about a normal 
character of the breast-milk or whether a mixed feed- 
ing is necessary. 



MIXED FEEDING. 

By the term "mixed feeding" we mean that a 
baby is fed partly on his mother's breast-milk and 
partly on cows' milk. If a breast-fed baby is not 
thriving, it may be advantageous to feed him a cows' 
milk mixture once or twice a day, along with his 
breast-milk feedings. Oftentimes it is well to feed 
him his 10 p.m. and 2 a.m. feeding from a bottle of 
cows' milk mixture, in order not to disturb his 
mother's rest if the mother is in a delicate condition. 

In using a cows' milk mixture in mixed feeding 
always choose a mixture for a baby that is quite a lit- 
tle younger than the baby in question; thus, if your 
baby is four months old and you wish to employ 
mixed feeding for any reason, put him on a cows' milk 
mixture that is intended for a baby one month old 
and gradually strengthen the feeding up to one which 
is for a baby of his age. There is a great difference 
between the proteids (curd) of breast-milk and the 
proteids of cows' milk, the cows' milk proteids being 
far less easily digestible ; therefore we employ a 
weaker formula of the cows' milk mixture when first 
giving cows' milk to a baby. 



WEANING. 65 



WEANING. 

When we speak of weaning a breast-fed baby it 
means that he is gradually given cows' milk or other 
articles of food to eat, in place of the exclusive diet of 
breast-milk on which he has been living since birth, 
When we speak of weaning a bottle-fed baby we 
mean that he is given other articles than cow's milk, 
such as broths, toast, eggs, etc. 

Many physicians agree that a breast-fed baby of 
six months should be gradually weaned. If a baby is 
born, say in September, he will be six months old 
in March ; it is then very much better that his mother 
should wean him and get him accustomed to cows' 
milk, especially as the hot summer months are ap- 
proaching, than it is to wait until he is eight months 
old and try to begin weaning him in the midsummer 
months. We cannot say that all babies should be 
weaned at this age or that age; this would be the 
height of folly. There are so many conditions which 
might arise in the case of any individual baby that 
might occasion his weaning at an earlier or later date 
that it should be left to the judgment of your physi- 
cian when your baby should be weaned. 

How should you wean a breast-fed baby? Begin 
by giving him one bottle each day (preferably in the 
middle of the forenoon) of a cows' milk mixture. 
One word as to this cows' milk mixture ; you should 
begin by giving him a much weaker formula of cows' 
milk mixture than is indicated by his age; thus, if 
your baby is six months old, begin by giving him one 
bottle each day of a formula (Formula I) that is in- 



66 THE PRACTICAL CARE OF THE BABY. 

tended for a baby of but two weeks. You do this for 
the simple reason that your baby has been living on 
breast-milk exclusively, and were you to give him a 
cows' milk mixture that would suit his age (six 
months), you would be putting into his stomach a 
mixture too strong for him to begin on, there being 
a great difference in the digestibility of cows' milk 
and breast-milk of the same percentages of fat, curd, 
and sugar (see "Modifications of Cows' Milk"). 

Continue giving him one bottle every day of this 
weak cows' milk mixture for four or five days ; watch 
his stools for evidences of indigestion (see "Bowels") ; 
also watch his weight. Notice whether the cows' 
milk mixture gives him colic. Give him the same 
quantity of cows' milk mixture each time as is set 
down for a baby six months old. 

If after four or five days no bad symptoms arise 
from this one bottle of weak cows' milk mixture, give 
him two bottles each day of the same formula ; one of 
these two bottles in the morning and the other toward 
evening. If no bad symptoms arise after a day or so, 
stop the breast-milk feedings entirely, and supplant 
them by bottles of the same weak cows' milk formula. 

If after a day or two no bad symptoms arise, in- 
crease the formula in strength ; that is to say, give 
the baby Formula II. Try this for two days, and, if 
all is well, increase the strength to Formula III, and 
so on up to Formula V, which is the correct formula 
for a child of six months. As the baby grows older, 
increase the formulas according to his age. If any 
symptoms of indigestion arise, go back to a weaker 
formula. A baby should not be given any more than 
he is able to digest. 



WEANING. 67 

What other food besides cows 1 milk mixture should 
baby eat? If a baby is weaned from the breast when 
he is six months old, he should have nothing but cows' 
milk mixture to eat, until he is eight to nine months 
old ; from this time to twelve months (nine to twelve 
months) of age he should be placed on Formula VI. 
At his noon meal he should have 3 ounces of fresh 
beef-juice (see "Food Recipes"). If you give him 
three ounces of beef-juice at his noon meal, lessen 
the amount of milk mixture that you give him at this 
meal by 3 ounces. This diet should be continued 
until he is one year old, when he should be given the 
food indicated under the heading "Diet Schedule for 
Children from the First to the Sixth Year of Age." 

How should you wean a bottle-fed baby? When a 
baby has been brought up on the bottle and has 
reached the age of nine months, he should be given 
Formula VI, then the food indicated under the head- 
ing "Diet Schedule for Children from the First to the 
Sixth Year of Age." 

Breast-fed babies should be taught from birth 
to drink water from a bottle, as this gets them accus- 
tomed to a bottle when weaning becomes necessary. 

As soon as a child is large enough to sit up to 
the dining-table, he should be allowed to do so ; he 
should eat with the rest of the family except on sun- 
dry occasions. He should be brought up to under- 
stand that he is to eat his food and his only. He 
should not be fed from his mother's plate ; he should 
have his own little bowl for cereals and the like, his 
own little milk-cup, and his own spoon, preferably a 
pap-spoon (Fig. 39). I have often seen and heard of 
the deplorable condition where baby had to eat his 



68 



THE PRACTICAL CARE OF THE BABY. 



meals away from everybody else, simply because his 
mother could not stand the strain of having her baby 
sit beside her, continually crying for things to eat 
which he could not have! Whose fault is it? Surely 
not baby's! 

I know of many babies who come to the table, 
eat their food, and never once think of asking or cry- 
ing for the food of any other person. Why? Be- 
cause they have been brought up to know that it is 
their food that they must eat ; they never have had a 
taste of any other food ; therefore, not knowing what 
it is, they never ask for it. A baby of one year may 




Fig. 39. — Pap-spoon. 



generally be taught to drink from a cup or a thick 
glass (he will bite and crack a thin one). Often an 
entire day of absolute starvation will have to be per- 
sisted in before baby will come to his senses and 
drink the milk that is placed before him in his cup; 
of course he must have encouragement and help. Do 
not make him take all his milk from a cup; usually 
his midday meal is a good one at which to practice 
the cup-drinking act. Baby should also be taught to 
eat with a spoon. I do not mean to convey the idea 
that all babies of one year or a year and a half will sit 
up to the table and behave like lambs, spill no milk, 



WEANING. 



69 



not turn their bowl upside down nor throw crumbs 
on the floor ! They all will do these things at times, 
because they are babies; but with a little care, gentle 
— but firm — perseverence,and a whole lot of patience, 
you can teach a baby the right way as well as to let 
him go the wrong way. 

Some one reading these lines will say : "What is 
the use of training a baby when he is so young ? Let 
him alone until he is two years old, then it will be 





Fig. 40. — Small English Nipple. Fig. 41. — Large Conical Nipple. 



easier to train him, as he will understand more." Yes, 
he will understand sl good deal more if you allow him 
to grow to the age of two years before teaching him 
the correct way to eat ! But it will be more in the 
wrong direction. "It will be easier to train him then" 
did I hear some one remark? Did you ever try to 
train a child that had had his own way until two years 
old? If you ever did try, you know the success (?) 
vou had. 



70 THE PRACTICAL CARE OF THE BABY. 



THE NIPPLE. 

A rubber nipple which nearest approaches the 
human breast-nipple in shape and action is the ideal 
one. There is a great variety of rubber nipples to be 



Fig. 42. — Correct Flow. 

found in almost every shop, and undoubtedly all have 
their individual merits. The ones which have proved 
valuable in my hands are two in number, namely : the 
small English nipple for very young infants (Fig. 40) 
and the somewhat larger conical nipple for older 
babies. The smaller English nipple is one of the 
exact size of Fig. 40, and is made of rather stiff rub- 



THE NIPPLE. 71 

ber, which prevents it from collapsing. This nipple 
has a single hole in the end, from which the milk 
should drop when the bottle is inverted. The hole 
may be enlarged by a red-hot needle if the supply 
of milk is not sufficient. 

The larger conical nipple is the exact size of Fig. 
41, and is a little more conical in shape than Fig. 40. 




It will fit any nursing-bottle. Oftentimes it will be 
found that this style of nipple as sold in the shops has 
too large a hole in the end ; frequently they are sold 
with two or three holes perforated in them. It is 
best to buy nonperforated nipples and perforate them 
with the hot needle. 

The milk should not run from a nipple when the 



n 



THE PRACTICAL CARE OF THE BABY. 






Fig. 44. — Various Forms of Rubber Nipples. 

bottle is inverted, but should drop rapidly. Figs. 42 
and 43 explain the right and wrong way in which the 
milk should come from a nipple. 





Fig. 45. — Various Forms of Rubber Nipples. 

There are nipples sold with supply-holes which 
would readily suggest some sort of "fire-extin- 



THE NIPPLE. 73 

guisher" rather than a nursing-bottle nipple. Hav- 
ing pointed out the two forms of nipples which have 
been most efficacious in my experience, I will simply 
give illustrations of some of the other common forms 
which are in use (see Figs. 44 and 45). 

The Care of the Nursing-bottle Nipple. — 
It is best to buy half a dozen nipples at a time, as they 




k 



Fig. 46. — Rubber Nipple Correctly PJaced on Nursing bottle. 

wear out quite rapidly. Before beginning the use of 
a rubber nipple, it should be boiled in water for ten 
minutes ; this frees it from any possible contamina- 
tion. Having boiled two or three for immediate use, 
put the others away until wanted. All rubber nipples 
in use should be kept in a covered dish or jar of boric 
acid solution ; this solution is prepared by dissolving 
a heaping tablespoonful of powdered boric acid in a 



^E PRACTICAL CARE OF THE BABY. 

quart of boiling water. The solution should be 
changed in the nipple-jar once a day, washing the 
nipples in hot water and filling up the jar from our 
quart supply of solution of boric acid. 

There is a right and a wrong way of putting a 
nipple on a nursing-bottle, as illustrated by Figs. 46 
and 47. In Fig. 47 the baby chews on the glass rim 
instead of sucking the nipple. 




Fig. 47. — Rubber Nipple Incobeectly Placed on Nursing-bottle. 



When a bottle of feeding is ready for the baby, 
a nipple should be taken from the nipple-jar of boric 
acid solution and placed on the bottle, as in Fig. 46. 
After the baby has finished a feeding, the nipple 
should be removed, washed in cold water, and placed 
back in the nipple-jar of boric acid solution. As soon 
as a nipple is found to be getting stiff, losing its elas- 
ticity, or torn, it should be thrown away. 



THE BOTTLE. 



75 



THE BOTTLE. 

There are two general styles of nursing-bottles 
that are usually employed, namely: the cylindrical 
variety (Figs. 48 and 49), and the other variety illus- 
trated by Fis^s. 50 and 51. 





Fiflr. 48. — Six-ounce Bottle. 



Fig. 49.— Eight-ounce Bottle. 



For general use the cylindrical kind is greatly 
preferable, as it is more easily cleaned, can be more 
easily carried, is more compact, and, furthermore, 
it will fit almost any sterilizer or pasteurizer. The 
only disadvantage of the cylindrical bottle is the 
fact that the largest bottle of that style holds only 
eight ounces ; if the baby consumes more than that 
amount at one feeding, it becomes necessary to em- 



76 



THE PRACTICAL CARE OF THE BABY. 



ploy a second bottle to complete the feeding. The 
advantages, however, more than counterbalance this 
seeming disadvantage. 

Nursing-bottles are usually made with a gradu- 
ated scale of ounces blown in the glass. It is al- 
ways well to have on hand at least a dozen cylin- 
drical nursing-bottles, for they are frequently broken 





Fig. 50. — Large Flat Nursing- 
bottle. 



Fig. 51/ — Large Flat Nursing- 
bottle. 



and new ones are required. Figs. 48 and 49 repre- 
sent the two sizes of bottles required by an artificially 
fed baby during its first year of life. Fig. 48 is a six- 
ounce bottle, and is used during the first five or six 
months ; Fig. 49 is an eight-ounce bottle, and is em- 
ployed until the baby learns to drink from a cup. 

The Care of the Nursing-bottle. — A baby's 
bottle is often the incubator in which many a case of 



THE BOTTLE. 77 

cholera infantum is hatched, and in more cases than 
we would suppose is it accountable for the summer 
diarrhoeas of children. A dirty nursing-bottle is cer- 
tainly a thing to be guarded against. Often we hear 
the argument advanced by some few mothers and 
nurses that "many bottle-fed babies have been reared 
in years gone by without such strict care having been 
paid to their nursing-bottle, and why will not babies 
of to-day get along just as well without all this fuss 
being made about them?" The old typhoid-fever 
argument which we have heard advanced by some 
rural inhabitant that "we have used this well-water 
for years, and look how healthy we all are ! Why 
should we reline our well or repair the drain?" This 
argument, I say, is just as flimsy as the one advanced 
regarding the dirty nursing-bottle. Probably some 
mothers rear babies and use dirty nursing-bottles; 
probably some families drink impure well-water for 
years and do not get typhoid fever ; but, let there once 
break out an epidemic of cholera infantum, on the 
one hand, or a few cases of typhoid fever, on the 
other, and then notice the effect upon the health of 
the "'dirty-bottle'' baby or the community using the 
so-called pure well-water ! 

The proper care of nursing-bottles is too often 
sadly neglected, especially during the period from the 
time the bottle has been drained by the baby to the 
time when it is once more to be filled with a newly 
prepared feeding. As soon as a child has completed 
a feeding the bottle should be thoroughly rinsed in 
cold water and scrubbed with a bottle-brush (obtained 
at any house-furnishing store). It should then be 
filled with cold water and allowed to stand in a clean 



IS 



THE PRACTICAL CARE OF THE BABY. 



place for several hours. A good plan is to have two 
sets of bottles, using each set on alternate days. 

When the contents of all the bottles for a day's 
and night's feeding has been consumed and the bot- 
tles treated in the above manner, they should be 
boiled before filling with the next new feeding. The 
method usually employed is to fill each bottle with 
cold water, set the bottles in a kettle of cold water, 
and allow them to come to a boil and boil for twenty 
minutes. In using this method we are obliged to 




Fig. 52. — The Author's Sterilizer, Pasteurizer, and Infants' 



A, Pail. B, Bottle-rack. C, Bottle-guard, which prevents the bottles 
from falling out. 

wait until the water has become cool before remov- 
ing the bottles, or to use a towel in handling them. 
Often, to cool them more rapidly, they are filled with 
cold water, thus breaking them ; if they do not break, 
this possibly introduces germs which are contained 
in the water from the hydrant. 

To obviate the delay and these embarrassing 
conditions, the author has devised the very simple 
apparatus illustrated by the accompanying cuts 



THE BOTTLE. 



79 



(Figs. 52, 53, and 54). It consists of three parts: 1. 
A bottle-rack. 2. A tin pail with a cover. 3. A 
circular bottle-guard which, when in position, pre- 
vents the inverted bottles from falling out. 

To Use the Apparatus for Boiling Bottles. 
— Fill the pail with cold water to the level of the sin- 
gle groove ; fill each bottle with cold water and set 
it in the bottle-rack. Having filled the rack with bot- 
tles, place the bottle-guard down over the two up- 
right pins and over the necks of all the bottles. Now 




Fig. 53. — Bottle-guard Fastened 
in Position by Pins. (It fits 
over the necks of the bottles.) 




Fig. 54. — Inverted Bottle-rack. 
(Bottle-guard [Fig. 53] pre- 
vents the bottles falling.) 



put the two movable pins (on chains) through their 
corresponding holes in the two uprights and place 
the rack in the pail. 

Put on the cover to the pail, set the pail on the 
stove, and allow the water to boil for half an hour. 
To remove the rack, lift it from the pail by means of 
the two handles, take it to the sink, invert it (now 
using the handles on the bottom of the rack), and let 
the water run out of the bottles. 



80 THE PRACTICAL CARE OF THE BABY. 

We may now set the rack aside, still in the in- 
verted position, and allow the bottles to drain thor- 
oughly. The bottles have been boiled, removed from 
the pail, and drained without being touched by the 
hand. Let the bottles remain in the rack until wanted 
for the new feeding. 

This apparatus can also be used as a pasteurizer 
or sterilizer as described later on when dealing with 
the subjects of pasteurization and sterilization. It 
also may be used as a temporary refrigerator, by 
packing the feedings in ice. It is manufactured in 
two sizes : one holding ten six-ounce bottles, the 
other holding seven eight-ounce bottles. The one 
pail takes the two different-sized bottle-racks. 






UTENSILS REQUIRED FOR THE HOME=MODIFI~ 
CATION OF COWS' MILK. 

One dozen cylindrical (six- or eight- ounce) glass 
bottles. These bottles should be graduated in ounces ; 
that is, they should have the ounces marked off in the 
glass. The six-ounce bottles are far more convenient 
to use when baby is very young; when he reaches six 
months, the eight-ounce bottles are best. The eight- 
ounce bottles may, however, be used from birth. 

A tin breadpan in which bottles of feeding are 
stood in the ice-box. 

One pound of nonabsorbent cotton with which to 
stopper the feeding-bottles. 

One sixteen - ounce glass graduate (marked in 
ounces), to be used as a measure for milk, cream, etc. 



UTENSILS FOR MODIFYING MILK. 



81 



A small one-ounce tin dipper with which to remove 
cream from the top of a quart bottle of milk. These 
dippers were designed by Dr. Henry Dwight Chapin, 
of New York, and may be had from the Cereo Com- 
pany, of Tappan, N. Y. 

One glass funnel with which to fill feeding-bottles. 

One tablespoon. 

One large earthenware or glass pitcher (two quarts) 
in which to mix feedings. 

One large tin tray. 




Fig. 55. — Utensils Required for the Home-modification of 
Cows' Milk. 



I. Glass graduate. 
II. Large crockery or glass pitcher. 

III. Glass funnel. 

IV. Tablespoon. 

V. Tin dipper for cream. 



VI. Tin breadpan. 
VII. Nonabsorbent cotton. 
VIII. Large tray. 
IX. Bottles. 



Also two one-quart bottles of GOOD milk every 
morning. These bottles should not be shaken, as the 
layer of cream is not to be disturbed until time to 
make the feedings. 

Also a one-pound box of sugar of milk and an 
eight-ounce bottle of limewater. 



82 THE PRACTICAL CARE OF THE BABY. 



MODIFICATION OF COWS' MILK. 

Modification of cows' milk means that the cows' 
milk is changed to about the same composition as 
breast-milk. The following two approximate anal- 
yses — one of cows' milk and the other of breast-milk 
— show the different amounts of the same ingredients 
contained in both : — 

Cows' Milk. Bkeast-milk. 

Fat 4.00 Fat 4.00 

Sugar 4.00 Sugar 7.00 

Proteids 4.00 Proteids 1.50 



We see from the above analyses that in modify- 
ing cows' milk to the composition of breast-milk we 
must do two things : — 

1. Add more sugar. 

2. Take out proteids. 

As cows' milk is acid, it is necessary that we 
should add limewater to it, so as to render it alkaline, 
like breast-milk. 

1. We supply the sugar in the form of milk- 
sugar. 

2. We take out the excess of proteids (curd) by 
diluting cows' milk with water. 

If we were to give an infant pure, undiluted cows' 
milk, we would see that this infant would be taking 
far too much proteids and would not be getting 
enough sugar; as a result we would soon have an 
overfed baby, with constipation or diarrhoea and all 
forms of indigestion. 



SCHEDULE OF INGREDIENTS OF FEEDING. 



83 



SCHEDULE OF INGREDIENTS OF FEEDINGS FOR 
BABIES, FROM BIRTH TO ONE YEAR. 

The milk-feeding formulas which I consider the 
best and easiest of comprehension are those set forth 
by Dr. L. Emmett Holt, of New York, and fully de- 
scribed in his admirable little book entitled "The Care 
and Feeding of Children." I have taken the follow- 
ing live milk-formulae directly from this book, as they 
are the most simple and have proved in my experi- 
ence to be the best. 

"When a mother cannot or does not wish (an un- 
pardonable sin) to nurse her baby, he must be reared 
upon the best substitute for mothers' milk, which sub- 
stitute is cows' milk. That baby should have nothing 
to drink but warm sugar-water until he is twenty-four 
hours old. This sugar-water is made by dissolving 
1 level tablespoonful of milk-sugar (or 1 level tea- 
spoonful of granulated sugar) to 8 ounces of water 
that has been boiled. Feed him 1 to 2 ounces of this 
warm sugar-water every two hours for twenty-four 
hours ; then begin on Formula I. 

FOEMULA I (THFED TO FOI'ETEEXTH Day). 





QUANTITY OF EACH REQUIRED TO MAKE 




12 OZ. 


16 oz. 


20 oz. 


24 oz. 


Milk ounces 

Cream do. 

Limewater .... do. 
Water . do. . 
Milk-sugar 'even tablespoonfuls) 


1 

\ 

4 

n 


1} 
1} 
1 
121 
2 


H 
U 

15 h 


2 
2 

3 



Ten feedings. Feed every two hours from 6 A.M. to 10 P.M. 
also at 2 A.M. Quantity, 1 to 2\ ounces. 



Feed 



84 THE PRACTICAL CARE OF THE BABY. 

Foemula II (Second to Sixth Week). 





QUANTITY 


OF EACH 


REQUIRED 


TO MAKE 


Ingredients. 










20 oz. 


24 oz. 


28 OZ. 


32 oz. 


Milk ....... ounces 


2 


2* 


3 


3} 


Cream do. 


2 


2* 


3 


31 


Limewater ........... do. 


1* 


1* 


1* 


2 


Water do. . 


14* 


17* 


20* 


23* 


Milk sugar (even tablespoonf uls ) 


2* 


3 


3* 


4 



Ten feedings. Feed every two hours from 6 A.M. to 10 P.M. Feed 
also at 2 A.M. Quantity, 2 to 3J- ounces. 



Formula III (Sixth 


to Eleventh Week). 






QUANTITY 


OF EACH REQUIRED 


TO MAKE 












24 OZ. 


28 OZ. 


82 oz. 


36 oz. 


Milk „ ounces . 


3 


3* 


4 


4* 


Cream do. 


3 


3* 


4 


4* 


Limewater do. . . 


1* 


1* 


1* 


1* 


Water do. . 


16* 


19* 


22* 


25* 


Milk-sugar (even tablespoonf uls) 


3 


3* 


4 


4* 



Eight feedings. Feed every two and a half houis from 6 A.M. to 
10 p.m. Feed also at 2 A.M. Quantity, 3 to 4* ounces. 

Formula IV (Tenth Week to Fifth Month). 





QUANTITY OF EACH REQUIRED TO MAKE 




28 oz. 


35 oz. 


42 oz. 


Milk ounces 

Cream do. . . 

Limewater do. . . 

Water do. 

Milk-sugar ( even tablespoonf uls ) 


8 
3* 

l* 

15 

3* 


10 
4 

1* 
19* 

4* 


12 
5 
2 
23 

5* 



Seven feedings. Feed every three hours from 6 A.M. to 10 P.M. 
Feed also at 2 a.m. Quantity, 4 to 6 ounces. 



SCHEDULE OF INGREDIENTS OF FEEDING. 85 
Foemula V (Fifth to Tenth Month). 





Ingredients. 


QUANTITY 


OF EACH 


REQUIRED 


TO MAKE 




30 oz. 


36 oz. 


42 oz. 


48 oz. 


Milk 


ounces 


m 


J3J 


15| 


18 


Cream 


do. . 


3| 


% 
u 


2 


6 


Li me water 


do. 


2 


Water 


do. . . 


13| 


16 2 L 


19 


22 


Milk-sugar 


(even tablespoonfuls) 


4 


^ 


5^ 


6* 



Six feedings. Feed every three hours from 6 A.M. to 10 p.m. No 
feeding between 10 P.M. and 6 A.M. Quantity, 5 to 8 ounces. 

Baby will generally drop his 2 a.m. feeding him- 
self, by sleeping through the entire night from 10 p.m. 
to 6 A.M. 

Barley-water or oatmeal-water may be substi- 
tuted in this formula for the plain boiled water. (See 
sections on "Diarrhoea" and "Constipation" regard- 
ing the use of barley-water and oatmeal-water.) 



Foemula VI (Tenth to Twelfth Month 



Ingredients. 




QUANTITY OF 
REQUIRED TO 


EACH 
MAKE 




42 oz. 


48 oz. 


Milk 

Cream 


ounces 
. do. 


19 \ 

5! 
2 
15 
4 




21| 

6£ 


Limewater 


. do. . 


2 


Water 


Ho. . . 


18 


Milk-sugar (even tablespoonfuls) .... 


5 



Five feedings. Feed every three and a half hours from 6 a.m. to 
10 p.m. Quantity, 6 to 9 ounces. 



86 THE PRACTICAL CARE OF THE BABY. 





:■: :■ ■* : fi''?S 



Fig. 56. — Correct Position during Feeding. 



At the midday meal from 1 to 3 ounces of freshly 
prepared beef-juice should be given and the quantity 
of feeding lessened by from one to three ounces at 
this meal. 



DIET SCHEDULE FOR CHILDREN. 87 



DIET SCHEDULE FOR CHILDREN FROM THE 
FIRST TO THE SIXTH YEAR OF AGE. 

TWELFTH TO FIFTEENTH MONTH (FIVE MEALS 
DAILY). 

7 a.m. — Eight to 10 ounces of milk made after 
the following formula : — 

Milk 30 ounces. 

Cream 5 

Water 15 

Milk-sugar 10 teaspoonfuls. 

This quantity will usually be sufficient for the 
day's supply. It is best to make the feedings all 
at once early in the morning and keep the milk in 
8-ounce feeding bottles stoppered with nonabsorbent 
cotton, on ice. 

9 a.m. — The strained juice of an orange. 

11 a.m. — Eight to 10 ounces of milk of above 
formula. 

2.30 p.m. — Four to 6 ounces of chicken-, mut- 
ton-, or beef- broth and 4 to 6 ounces of milk of 
above formula. Or 

One poached or soft-boiled egg, with a piece of 
zwieback and 4 to 6 ounces of milk of above for- 
mula. Or 

Two to 3 ounces of fresh beef-juice and 6 to 8 
ounces of milk of above formula. Or 

Four to 6 ounces of oatmeal- or barley- gruel 
added to 4 to 6 ounces of milk of above formula, and 
a piece of zwieback or stale bread. 



88 THE PRACTICAL CARE OF THE BABY. 

6 p.m. — Six to 8 ounces of milk of above form- 
ula, with 2 ounces of barley- or oatmeal- gruel added. 

10 p.m. — Eight to 10 ounces of milk of above 
formula. 



FIFTEENTH TO TWENTIETH MONTH (FIVE MEALS 
DAILY). 

7 a.m. — A well-cooked cereal, and milk of the 
following formula: — 

Milk 40 ounces. 

Cream 2*/ a " 

Water 7 1 /, " 

Milk-sugar 5 teaspoonfuls. 

The child should have milk (of above formula) 
on the cereal, and also a glass of same milk to drink. 
Every other day he may have an ounce of cream 
added to milk he eats on cereal. 

9 a.m.— Juice of one orange. 

11 a.m. — Eight to 10 ounces of milk of above 
formula, with 1 or 2 tablespoonfuls of a cereal jelly. 

2.30 p.m. — One to 3 ounces fresh beef-juice and 
4 to 6 ounces of milk of above formula. Or 

Four to 6 ounces of beef-, chicken-, or mutton- 
broth and 4 to 6 ounces of milk of above formula and 
a piece of zwieback. Or 

One poached or soft-boiled egg with stale bread 
crumbs, a piece of toast or zwieback, and a glass of 
milk. 

Dessert with any of the above selections for this 
meal: stewed prunes (no skins), 2 tablespoonfuls; 
baked apple, 2 tablespoonfuls; or custard. 



DIET SCHEDULE FOR CHILDREN. 89 

6 p.m. — Four to 6 ounces of milk of above 
formula with 4 to 6 ounces of barley- or oatmeal- 
gruel added. 

10 p.m. — Eight to 10 ounces of milk of above 
formula with 1 ounce of cereal jelly added. 



TWENTIETH TO TWENTY=FOURTH MONTH (FOUR 
MEALS DAILY). 

1 a.m. — A dish of some well-cooked cereal with 
milk, piece of stale bread or zwieback, and 4 to 6 
ounces of milk. 

9 a.m. — Juice of an orange. 

10.30 a.m. — Ten to 12 ounces of milk. 

2 p.m. — One tablespoonful of scraped beef or 
scraped mutton, stale bread or zwieback, and 4 to 6 
ounces of milk. Or 

One to 3 ounces of fresh beef-juice, stale bread 
or zwieback, and 4 to 6 ounces of milk. Or 

Four to 6 ounces of beef-, mutton-, or chicken- 
broth, stale bread, toast, or zwieback, and 4 to 6 
ounces of milk. Or 

A poached or soft-boiled egg on a small well- 
baked potato, toast, stale bread, or zwieback, and 4 
to 6 ounces of milk. 

Dessert with any of the above-selected meals, 
such as stewed prunes (no skins), 2 to 3 tablespoon- 
fuls, or baked apple. 

6 p.m. — Eight to 10 ounces of milk, with 2 
ounces of a cereal jelly added. 



90 THE PRACTICAL CARE OF THE BABY. 



TWO TO THREE YEARS OF AGE (THREE MEALS 
DAILY). 

Breakfast (7.30 a.m.). — Oatmeal, hominy, fa- 
rina, wheaten grits, rice, or any* cereal (well cooked), 
and rich milk and a small amount of granulated 
sugar. The cereal should be well salted. A soft- 
boiled or poached egg should be given every other 
day. Stale bread, zwieback, toast, Graham crackers. 
A glass of milk. 

The juice of an orange should be given between 
breakfast and dinner. 

Dinner (12.30 p.m.). — Rare steak, rare mutton- 
chop, rare roast beef, white meat of chicken, baked 
or mashed potato with cream, spinach, fresh string 
beans, fresh peas, and stewed celery — cook all vege- 
tables well. Mutton-, beef-, or chicken- broth (may 
be thickened with arrowroot or cornstarch). Stale 
bread, zwieback, or oatmeal crackers. A glass of 
milk. Dessert: baked apple, stewed prunes, rice 
pudding, or custard. 

Supper (6 p.m.). — A well-cooked cereal and milk. 
Stale bread in milk ; occasionally a small cup custard. 
Graham crackers, dried bread, or zwieback. 



DIET SCHEDULE FOR CHILDREN. 91 



THREE TO SIX YEARS OF AGE (THREE MEALS 
DAILY). 

Breakfast (7 to 8 a.m.). — Oatmeal, hominy, 
wheat en grits, rice, farina, or any well-cooked cereal, 
and rich milk and a small amount of granulated 
sugar. The cereals should be well salted. A soft- 
boiled or poached egg. Bread and butter. Graham 
or gluten crackers. A glass of milk. 

Dinner (12 to 1). — Broths and soups, lamb, 
rare roast beef, rare steak or mutton, white meat of 
chicken, or fresh fish (broiled or boiled). Baked or 
mashed potatoes, asparagus-tips, spinach, stewed 
celery, fresh string beans and fresh peas, orange, 
baked apple, stewed prunes, rice pudding, tapioca 
pudding, bread pudding, junket, and plain custard. 
Ice cream occasionally. 

Supper (6 to 7 p.m.). — A well-cooked cereal and 
milk. Stale bread in milk, arrowroot pudding, dried 
bread, Graham crackers, zwieback, and milk toast. 
A glass of milk. 

A well child should never be allowed to eat any- 
thing between meals. 

Cool boiled water should be given to the child to 
drink between meals. 



92 THE PRACTICAL CARE OF THE BABY. 



SPECIAL CONDITIONS REQUIRING CHANGE IN 
FOOD INGREDIENTS. 

1. Baby seems all right, but he does not gain in 

weight. 
Augment his food in quantity; if there is still no 
gain in weight, strengthen his food in quality. 

2. Baby is hungry ; he cries, sucks his fingers, sleeps 

poorly, etc. 
First increase his food in quantity and then in 
quality. 

3. Baby vomits immediately after being fed. 

He has been fed too much in quantity or he has 
been "jounced about" too soon after being 
fed. Milk mixture may be too strong. 

4. See chapter on "Stools." 

5. Baby regurgitates sour milk between his feedings. 

The feedings contain too much cream or the milk 
may have been sour when given to the baby, 
or milk mixture may be too strong. 

6. Baby has colic after feeding. 

Too much proteids. Dilute the feedings more. 

7. When baby is teething, has any fever, or does not 

feel well. 
The feedings should always be diluted by at 
least one-fourth the original strength and in 
some instances to one-half strength. 

8. Loss of appetite. 

Diminish strength of food. 



PREPARATION OF FEEDINGS IN DETAIL. 



93 



PREPARATION OF THE FEEDINGS IN DETAIL. 

Have ready all the articles shown in Fig. 55. Be 
sure that all these utensils are clean. Rinse each of 
them in cold water immediately before using. Bring 
the two one-quart bottles of milk from the icebox and 
begin preparing the feedings immediately. Be sure 




Fig. 57. — Chapiirs Dipper. 



that your hands are clean. Place in the one-pint 
graduated glass measure the number of tablespoon- 
fuls of milk-sugar required by the formula which you 
are using. Now add the water which has been boiled 
and allowed to cool somewhat. Mix the sugar and 
water together thoroughly by means of a tablespoon 
until the sugar has dissolved; pour this sugar-and- 



94: THE PRACTICAL CARE OF THE BABY. 

water mixture into the large pitcher. Now add the 
required number of ounces of limewater to the sugar- 
and-water solution in the pitcher. 

We then remove the cap from one of the quart 
milk bottles and carefully, by means of a teaspoon, 
remove sufficient cream from the top (gravity cream) 
to allow the tin cream-dipper to enter the bottle with- 
out overflowing the bottle. The cream-dipper is let 
down into the bottle and the cream will run into the 
dipper by displacement (Fig. 57). Measure the re- 
quired number of ounces of cream and place this 
cream in the large pitcher. Always taste the cream 
and milk, using a separate spoon, to see if they are 
perfectly sweet. 

The milk spoken of in our formula is what is 
known as "whole milk." We obtain whole milk by 
taking a full bottle, consisting of upper part gravity 
cream and the lower part of milk (Fig. 57), and in- 
verting this bottle several times, thus mixing the 
cream and the milk together; this mixture is called 
"whole milk." We measure the required number of 
ounces of whole milk from the full quart bottle of 
milk which we have not as yet used. Thus you will 
see the necessity of having two one-quart bottles of 
milk, as we use the cream from one bottle and the 
whole milk from the other. Having measured the 
required number of ounces of whole milk, we place 
it also in the large pitcher. Now give the entire mix- 
ture a few good stirs with a tablespoon so as to mix 
it thoroughly, and we are ready to fill the bottles. 

The bottles are filled by means of a glass funnel 
and are stoppered with pieces of nonabsorbent cotton 
and placed immediately on ice until wanted. 



CARE OF FEEDINGS IN SUMMER. 95 



CARE OF FEEDINGS IN SUMMER. 

Too much stress cannot be laid upon the impor- 
tance of the care of baby's feedings during the hot 
summer months. The room where the feedings are 
made should be as cool as possible. The feed- 
ings should be prepared in the quickest time possible. 
The quart bottles of milk from which the feedings are 
made should be brought directly from the icebox and 
used immediately ; they should not stand around for 
any length of time before you are ready to make the 
feedings. As soon as the feedings are all made they 
should be placed at once in the icebox; the icebox 
door should always remain closed except when open- 
ing the icebox to procure a feeding. 

When baby is ready for a bottle, it should be 
brought from the icebox, heated, and given to the 
baby immediately. Be sure that there is always suf- 
ficient ice in the icebox to keep the milk cold. After 
baby has drained his bottle, the bottle should be 
rinsed and filled immediately with cold water (see 
"Bottle"). During the hot months where a young 
infant is being fed, and especially where a change of 
milk-supply is inevitable (such as is occasioned by re- 
moval to country), the feedings should be pasteurized 
(see "Pasteurization"). In the event of an epidemic 
of scarlet fever or any contagious disease in the vicin- 
ity or along the milk-route, all the milk should be 
sterilized (see "Sterilization"). Where there is any 
possibility that the milk-supply may become contam- 
inated, I should advise sterilization of the feed- 
ings. If you are sure of the good and uncontaminated 



96 THE PRACTICAL CARE OF THE BABY. 

supply of your cows' milk and your baby is over six 
months old, I prefer raw milk (neither pasteurized 
nor sterilized). If you are going on a short trip of a 
day on a train or boat during the hot months, the 
day's feedings should be sterilized and packed in ice. 
If you live in the country and use the milk from your 
own cows, be sure that the milk is brought directly 
from milking, in a clean pail, by a person with 
clean hands, and placed immediately in pans in a large 
cool place, such as a cool cellar. Ahvays taste of a 
feeding immediately before giving it to a baby. Do 
not put your mouth to the nipple, use a spoon. Taste 
of it to see whether it is sour. Keep the feedings on 
ice. If your ice runs out, place the bottles in cold 
water in a cool place; change the water frequently. 
It is best to have a small separate icebox to hold noth- 
ing but the feedings. 



PASTEURIZATION. 

Pasteurization consists in heating the milk to a 
temperature of 160° F. for a period of forty-five min- 
utes. Babies fed on pasteurized milk do not become 
as constipated as when they are fed on sterilized 
milk. Pasteurization does not cause any alteration 
in the constituents of the milk, and is useful in cases 
where a young infant is being fed and where you are 
not perfectly sure of the supply of pure, cows' milk. 
During the very hot parts of the summer months I 
should advise pasteurization in all cases where the 
baby is not six months old. 

The author's combined apparatus for pasteuriza- 



PASTEURIZATION. 97 

tion and sterilization is explained in the following 
text : — 

To Use the Apparatus as a Pasteurizer for 
Milk. — Fill the pail (see Fig. 52) with water to the 
level of the single groove. Place on the cover and let 
the water come to a boil. Fill the bottles with the 
feeding to be pasteurized, and set them away in a re- 
frigerator or allow them to stand in cold water and 
become cool. When the feeding has been cooled, set 
each bottle in its place in the bottle-rack, remove the 




Fig. 58. — Arrangement of Author's Apparatus for Rapidly- 
Cooling the Milk after Pasteurization or Sterilization. 

pail from the stove, and set the rack full of bottles 
down in the pail of boiling water ; put on the cover. 
Set the pail on a board or wooden shelf for forty-five 
minutes. This keeps the milk at a temperature of 
about 160° F. for thirty-five minutes. 

If all the bottles which the rack holds are not 
needed for pasteurization, then fill the bottles not 
needed with cold water ; each receptacle in the bottle- 
rack must contain a bottle filled with either milk or 
cold water. 



98 THE PRACTICAL CARE OF THE BABY. 

To Cool the Milk. — Lift the rack from the pail 
and bend down the three wire legs from the bottom 
of the rack. Now set the rack back in the pail of hot 
water; the rack will be found to project above the 
edge of the pail, owing to the use of the legs. Place 
the whole apparatus in a sink and allow cold water to 
run from a faucet into the pail for half an hour (Fig. 
58). If running water is not available, pour cold 
water into the pail by means of .a pitcher, the cold 
water gradually taking the place of the hot water. 
When the bottles are thoroughly cool place them in a 
refrigerator until wanted. 

The fact of the bottles having been previously 
boiled and allowed to cool anneals the glass and pre- 
vents their breaking when plunged in the boiling 
water during the process of pasteurization. 

By the use of this simple apparatus we have com- 
bined three essential features for the rational feeding 
of bottle-fed infants, namely: (1) a perfectly clean 
bottle, (2) a sterilizer, and (3) a pasteurizer. 



STERILIZATION. 



Sterilization consists in heating the milk to a 
temperature of 212° F. and keeping it at this tem- 
perature for half an hour or so. Sterilization is useful 
when you have a long journey to go and wish the 
baby's feeding to keep fresh as long as possible. Ster- 
ilization is useful when crossing the ocean, as the 
whole week's feedings are made at one time just be- 
fore starting, are sterilized, and will keep fresh (on 
ice) until you reach the other side of the ocean. If a 



STERILIZATION. 99 

baby is fed for a considerable length of time on ster- 
ilized milk he will become constipated. Sterilization 
is useful in some instances during the hot summer 
months (see "Care of Feedings in Summer"). 

To Sterilize Milk. — Place the bottles full of 
feeding to be sterilized (each bottle stoppered with 
iwnabsorbent cotton) in a kettle of cold water. Let the 
water come halfway up on the bottles; the bottles 
should be standing. Let the water boil for an hour. 
Cool the bottles by allowing cold water gradually to 
run into the kettle of hot water; when cool, place 
the bottles on ice. The above is one way to sterilize 
feedings, but it is not the easiest way nor the most 
elegant. The Arnold sterilizer is a very useful ap- 
paratus. 

The author has devised an apparatus (see Figs. 
52. 53. 54, and 58) which can be used for sterilizing 
and pasteurizing feedings and which also is employed 
to thoroughly sterilize the nursing-bottle (a very es- 
sential thing). 

To Use the Apparatus as a Sterilizer for 
Milk. — Fill the pail (see Fig. 52) with cold water to 
the level of the double groove. Having filled the bot- 
tles with the feeding to be sterilized, put them in the 
rack. Stopper each bottle with a wad of nonabsorb- 
ent cotton and place the rack in the pail. Put on the 
cover and place the pail on the stove, allowing it to 
remain there for an hour after the water has com- 
menced to boil. This subjects the milk to a tempera- 
ture of 212 ° F. 

To Cool the Milk. — Lift the rack from the pail 
and bend down the three wire legs from the bottom 
of the rack. Xow set the rack back in the pail of hot 



100 THE PRACTICAL CARE OF THE BABY. 

water; the rack will be found to project above the 
edge of the pail, owing to the use of the legs. Place 
the whole apparatus in a sink and allow cold water to 
run from a faucet into the pail for half an hour (see 
Figi 58). If running water is not available, pour cold 
water into the pail by means of a pitcher, the cold 
water gradually displacing the hot water. When the 
bottles are thoroughly cool place them in a refrig- 
erator until wanted. 

Do not let the fact that you are feeding your 
baby on sterilized milk lessen your vigorous care of 
the baby's milk, as sterilized milk may become in- 
fected by germs of disease just as easily as can raw 
milk. In the opinion of the author, sterilization is 
overdone; what we should aim at is the establish- 
ment of a higher and purer standard of raw milk dis- 
tribution rather than try to cover up our faults and 
satisfy our conscience by the process of sterilization 
of the milk. 



CONDENSED MILK. 101 



CONDENSED MILK. 



There are two points regarding condensed milk 
to which the attention should be called : — 

1. It is one of the worst of foods upon which 
continually to feed a baby. 

2. It is one of the best foods upon which to 
"switch off" for a few days when baby is in a condi- 
tion requiring the absolute withdrawal of cows' milk, 
where he is in a locality where the supply of cows' 
milk is impure, or where a sea-voyage or a train-trip 
is to be entered upon. 

Condensed milk contains less fat and less proteid 
than cows' milk. When we speak of condensed milk 
as being an improper food upon which continually to 
feed a baby, we have reference simply to a mixture 
of condensed milk and water. We have all seen these 
"condensed-milk" babies, as they are called, which 
are the boast of their parents or nurse that they 
have been raised upon nothing but condensed milk. 
"See how fat my baby is !" says a fond mother. Yes, 
they grow fat and gain in weight far above the normal 
weight-curve ; but finally the crash comes — they have 
been fattened for the slaughter ! Their flesh becomes 
flabby, they have a white skin, they become restless, 
they suffer from indigestion, and after a while they 
drift into a condition of marasmus. These con- 
densed-milk babies cut their teeth late and have a 
hard time cutting them. Oftentimes baby gets a dis- 
ease called rickets before the mother actually realizes 
that there is anything the matter with him of a serious 
nature. If a condensed-milk baby gets what is known 



102 



THE PRACTICAL CARE OF THE BABY. 



as "summer complaint" it is with great difficulty that 
his life can be saved. I therefore beg of you, my 
readers, do not continually feed your baby upon a mix- 
ture of condensed milk and water. Yes, it is easy to 
prepare, but for a continued diet for a baby — don't 
use it ! ! 

Among the poor of a great city condensed milk 
saves thousands of lives each year. The poor mother 
usually has no icebox in which properly to keep cows' 
milk; so she feeds her baby during the extreme 
heated term upon condensed milk, and thus unawares 
she weakens his food in proteids during the heated 
term and makes an attack of cholera infantum less 
liable to occur. 

As a rule, when condensed milk is used, it is not 
made strong enough. The following gives the 
strength of properly prepared condensed milk : — 



For the first month of 

infant life 
For the second month 

of infant life 
For the third month 

of infant life 
For the fourth to s ; xth 

month of infant life 
After the sixth month 

of infant life 



use 1 part to 13 parts of barley-watei. 



U 11 u 



1 " 1 



1 " 10 



\l 1 n 



" 1 " 6 " 



tl {( 



(( u 



LIFTING BABIES. 



103 




$ 




Fig. 59. — Incorrect (Dangerous) Way to Lift a Baby. 
LIFTING BABIES. 

Many a baby has been paralyzed for life by being 
improperly lifted. Often have we seen a mother or 



104 



THE PRACTICAL CARE OF THE BABY. 




Fig. 60. — Correct Way to Lift an Infant. 

nurse lift a baby by his hands, not taking hold of his 
body at all (Fig. 59). 

To Lift an Infant. — Place your left hand under 
his head and shoulders; and with your right hand 



LIFTING BABIES. 



105 





Fig. 61.— Correct Way to Lift a Baby. 

grasp his clothing and his feet; lift him in this man- 
ner (Fig. 60). 

To Lift a Child. — Place your hands one under 
each of his arms and press lightly toward his body 



106 THE PRACTICAL CARE OF THE BABY. 





Fig. 62.— Correct Way to Lift a Baby. 



(Figs. 61 and 62). Never lift a baby or child by his 



arms! 



CARRYING BABIES. 



107 




Fig. 63.— Correct Way to Carry a Baby. 

CARRYING BABIES. 

A young infant is far better off snugly tucked in 
his carriage when taken out of doors than he is when 



108 



THE PRACTICAL CARE OF THE BABY. 




Fig. 64. — Incorrect Way to Carry a Baby. 



carried out of doors in the arms of his mother or 
nurse. I do not believe in giving baby his airing car- 
ried about in his nurse's arms. 



TEMPERATURE. 109 

Figs. 63 and 64 illustrate the correct and the in- 
correct ways in which to carry a baby. 



TEMPERATURE. 



The normal temperature of a baby is about 99° 
F. This temperature is taken in the rectum. The 
temperature is taken by means of a clinical thermom- 
eter (Fig. 65). Clinical thermometers may be pur- 
chased at any good drugstore and cost from seventy- 
live cents to two dollars. It pays to buy a good certi- 
fied thermometer. The evening temperature of a 



, . i'iiiiiiii:i|iiiiiiiii'iiiiii|iiiii|iiii|[iiijiiiiiiii|[|iiiiiiiiiii|iiiiiiin|iiii| 

90 5 ^100 5 ' 110^ 



Fig. 65. — Clinical Thermometer. 

healthy baby is usually a very little higher than the 
morning temperature. 

To Take Baby's Temperature. — Place him on 
your lap as in Fig. 32. Having shaken the mercury 
column of the thermometer by a swinging motion 
down to 97 degrees, slip the end containing the mer- 
cury into baby's rectum a distance of one inch. Allow 
it to remain there for three minutes, remove it, and 
read it. Buy a self-registering thermometer in which 
the mercury column remains stationary when the 
thermometer is removed from the rectum. 

It does not take much to make baby's tempera- 
ture rise one or two degrees ; a slight cold or a tooth 
coming through will often raise the temperature a 
degree or two. In some diseases the temperature 



110 THE PRACTICAL CARE OF THE BABY. 

rises to 105 or 106 degrees. In rinsing the thermom- 
eter after use nothing but cold water should be used. 



EMERGENCIES. 



The following are some of the most common 
emergencies with which the young mother or nurse 
will have to deal. I do not mean to detract from the 
importance of summoning your physician at once 
whenever any of the majority of these conditions 
arise, nor do I mean for you to bother your physician 
every time the baby has a slight attack of colic. 
The remedies given are such as almost every mother 
has at her command, and they will not interfere with 
any treatment your physician may advise upon his 
arrival. 

Colic. — Place 2 or 3 soda-mint granules' in baby's 
mouth, or dissolve from 10 to 15 of the granules in 
6 ounces of hot water and give the baby 1 or 2 
ounces of the soda-mint water thus made. Let 
the baby lie against a hot-water bag, the bag being 
against his abdomen; see that the bag is well pro- 
tected by flannel so as not to burn the baby. Hold 
the baby against your shoulder and rub his back (see 
Fig. 66) ; gas will presently pass up from his stomach 
and possibly from his bowel through the rectum, and 
the little "bubble" which caused his colic will have 
disappeared. 

In habitual colic the food is probably too rich, 
especially in the proteids (curd). 

Convulsions. — Place the baby immediately in 
a warm bath of 110 degrees. Rub his legs, arms, and 



EMERGENCIES. 



Ill 




l 'Mm 

Fig. 66. — Position of Infant during Colic. 



body, and keep ice on his head. Give him castor-oil 
(under 6 months, 1 / 2 teaspoonful ; over 6 months, 1 
teaspoonful) by mouth if he can swallow. Give him 



112 THE PRACTICAL CARE OF THE BABY. 

an injection of warm, soapy water. Wrap him in 
warm blankets. 

Fever. — Dilute the milk one-half with water. 
Keep the baby in a cool, well-ventilated room away 
from other children. 

Earache. — Place a drop or two of warm sweet 
oil or glycerin in baby's ear. Place a hot cloth or hot- 
water bag to his ear ; be very careful, in using a hot- 
water bag, not to burn the baby's skin. 

Nosebleed. — Set the child up straight in a chair. 
Hold a small piece of ice wrapped in a handkerchief 
on the bridge of baby's nose for a few minutes. Try 
to quiet his fears. Pinch his nose with your thumb 
and finger. 

Foreign Body in the Nose. — Close one of the 
child's nostrils (the one not containing the foreign 
body), and try to make him blow his nose. Do not 
try to pick out the foreign body with a pin, hairpin, 
etc., as you will push it farther up his nose. 

Foreign Body in the Eye. — Use a solution of 
boric acid (see "Eyes"), and with a piece of absorbent 
cotton wet with this solution allow the solution to 
trickle into the corner of baby's eye. If this does not 
suffice to remove the body, take a small, round piece 
of wood or metal (a penholder or small pencil) and 
roll the upper eyelid over it; the offending particle 
will often be found on the inside of this upper eyelid, 
from which it may be removed with a small piece of 
absorbent cotton wet with the boric acid solution. 

Foreign Bodies Swallowed. — Babies often 
swallow buttons, pieces of straps from their car- 
riages, and all sorts of foreign bodies. Unless the 
object swallowed is sharp, or has sharp corners, no 



EMERGENCIES. 113 

attention need be paid to the baby, as the object 
swallowed will pass out the usual way with the stools. 
If the object is sharp do not give castor-oil nor any 
physic, as that only increases the danger. Give 
bread or crackers, as they will form about the object 
in the stomach or intestine and prevent its injuring 
the child. 

Choking. — Put your finger in baby's throat and 
see if you cannot pull up the offending substance ; if 
you cannot pull it up, push it down into his stomach 
(if it is a piece of bread or meat). Slap him on the 
back. Hold his head down and squeeze the sides of 
his body together. 

Chill. — Place the baby in bed and cover him up 
warm. Have hot-water bags or bottles placed at his 
feet and sides. 

Bleeding from the Umbilical Cord. — Tie a 
piece of fine tape around the cord between the baby's 
body and the bleeding point. If the navel bleeds after 
the cord has dropped off, place your finger over the 
bleeding point and make steady pressure until med- 
ical aid arrives. 

Inflamed Eyes. — See "Eyes." 

Wounds. — Remove all clothing from the vicin- 
ity of the wound. Wash the wound with pure warm 
water. If there is great bleeding, tie a tight bandage 
between the wound and the heart. If the wound is at 
a place where you cannot tie a bandage (on chest or 
head), fold a handkerchief into a wad and make firm 
pressure directly on the bleeding point. After the 
bleeding has stopped place a compress wet with water 
on the wound and apply a firm bandage. 

Burns. — Apply a cloth smeared with vaselin to 



114 THE PRACTICAL CARE OF THE BABY. 




/ 




Fig. 87. — Method of Holding Child for an Examination 
of the Throat. 



the burned area and apply a loose bandage. If the 
part is only scalded, apply a paste made with cooking 
soda (bicarbonate of soda) and water. 



EMERGENCIES. 115 

Foreign Bodies in the Ear. — Pull the ear out 
straight from the head and turn the child on the side 




Fig. 68. — Throat Examination of Infants. 

where the foreign body is located. By this pro- 
cedure the foreign body may roll out. 



116 



THE PRACTICAL CARE OF THE BABY. 



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MEASLES. 117 

Vomiting. — Keep away from all food for some 
hours. Reduce the strength of food. Let the baby 
suck a small piece of ice wrapped in a handkerchief. 
Babies will often, in perfect health, regurgitate a 
small part of their feeding, and this regurgitation 
must not be confounded with the term "vomiting." 
Severe diseases are often ushered in by vomiting. 

Examination of the Throat. — In an emer- 
gency, a teaspoon or the handle of a tablespoon may 
be used to depress the tongue ; after an examination 
of the throat the spoon should be boiled before using 
again. Better than a spoon are the small wooden 
spatulas sold by druggists, which may be burned after 
use. 



MEASLES. 



Measles is a highly contagious, eruptive fever 
that is attended by a catarrh of the nose, throat, 
eyes, and air-passages. Measles is one of the most 
contagious diseases of childhood. It is usually com- 
municated by direct contact, but it also may be 
spread by means of a third person. The disease is 
most contagious at the beginning of an attack, as the 
nasal discharge and the saliva are very highly con- 
tagious. 

The incubation period of measles (time from ex- 
posure to the disease to onset of first symptoms) is 
from six to fourteen days. The child is restless, has 
a running nose, the light hurts his eyes, he has a 
short cough, and may have a headache. In young 
babies a convulsion may be the initial symptom. 



118 THE PRACTICAL CARE OF THE BABY. 

Slight fever (101° to 102° F.) accompanies the onset 
of measles. There is usually some sore throat, and 
upon examination the throat is found to be very red. 
The rash appears about the fourth day ; it consists of 
red blotches scattered over the body; it is first 
noticed on the forehead, and rapidly spreads over the 
chest, abdomen, arms, and legs. The eruption fades 
away when pressure is made on the skin, but it rap- 
idly returns when this pressure is removed. The 
fever now rises to about 104° F. The rash begins to 
fade within a day or two after it makes its appear- 
ance. There is a peculiar odor attached to measles, 
and in some instances a diagnosis has been made by 
the smell alone. As the rash begins to fade, fine, 
meallike scales are noticed on the skin. These scales 
fall off, and constitute the desquamative period. A 
child with measles should be quarantined; his food 
should be weakened and he should be under the care 
of the physician, as oftentimes the worst sequels re- 
sult from the slightest cases. 

There seems to be a mistaken idea among the 
laity that all children are obliged to have measles some 
time during their lives, and therefore it is best for the 
children to have the disease while young, and get 
through with it, as the parents express it! I have 
known families in which there were numerous chil- 
dren, the parents of whom would actually court infec- 
tion, and wonder when the day would come when their 
children would all have the measles together! If a 
child in a large family of children comes down with 
measles, I often hear the remark when I insist on 
quarantine : "Oh ! why not let the other children get 
it and all have it together ?" The parents might as 



SCARLET FEVER. 119 

well say: "Our children have to die some time; why 
not let them die now?" 

Measles of itself is not to be feared, but the com- 
plications of this disease are legion ; it depends upon 
the care given a case of measles whether that child 
will have a complication of pneumonia or be left with 
running ears or sore eyes. One attack usually pro- 
tects one from a second attack, but there are cases on 
record of two or three attacks of genuine measles oc- 
curring in the same person. 



SCARLET FEVER. 

Scarlet fever also is a highly contagious disease, 
and is characterized by high fever, a rash, and a sore 
throat. It is one of the worst to be feared of the dis- 
eases of childhood. Scarlet fever is caused by an 
unknown germ, and may be communicated from one 
person to another by direct contact or by means of a 
third person carrying the contagium from the patient 
to the well child. 

The incubation period of scarlet fever (the time 
from exposure to the first symptom) is from 
three to nine days; this period, however, is very 
variable. The disease usually lasts from three to six 
weeks. A child that is coming down with scarlet 
fever usually becomes ill suddenly. He will have a 
vomiting spell; high fever (103° to 105° F.); hot, 
dry skin ; flushed face ; sore and red throat, and a 
coated tongue, through the coating of which show a 
few red points (the so-called "strawberry" tongue). 
In infants the disease may be ushered in by a convul- 
sion. 



120 THE PRACTICAL CARE OF THE BABY. 

The rash appears as small, bright-red spots 
about the size of the head of a pin ; these spots grad- 
ually become more numerous until the skin becomes 
bright red, almost as though it had been dyed scarlet. 
The rash is at its height about the fourth day, and 
then it begins to fade. The skin then "peels," ac- 
companied by intense itching. The contagium is 
carried in these scales. A child should not be pro- 
nounced free from contagion until the desquamation 
has been entirely completed. The soles of the feet 
and palms of the hands are usually the last portions 
of skin to desquamate. 

The complications of scarlet fever are numerous 
and include affections of nearly every organ in the 
body. A child with scarlet fever should be strictly 
quarantined and his food should be weakened ; when 
the disease occurs in older children, their diet should 
be limited to fluids. They should be given all the 
cool water that they desire. The skin may be 
sponged with warm water thrice daily, and after- 
ward anointed with vaselin. 



CHICKEN=POX. 



Chicken-pox is essentially a disease of childhood. 
It is highly contagious, and it very quickly spreads 
from one child to another. It may also be car- 
ried in the clothing from one child to another by 
means of a third person; this is not, however, the 
usual mode of infection, as a direct exposure is the 
common method of contracting the disease. Often- 
times children have chicken-pox for a number of days 



ADENOIDS. 121 

before the nature of the trouble is known ; they at- 
tend school and associate with their little friends as 
usual; their nurse has noticed a few small "pimples" 
scattered over the body, but she does not think that 
it is anything but a "disordered stomach" or a so- 
called "spring eruption" from some "blood impurity." 
Thus chicken-pox is spread. The child may feel ill 
and vomit his food when coming down with the dis- 
ease, while, on the other hand, the eruption may be 
the first sign of the trouble. 

The eruption first makes its appearance as red 
spots, these spots becoming raised "pimples," the 
centers of which soon change to a watery condition 
and finally dry up, leaving a crust. A child after an 
exposure to chicken-pox generally comes down with 
the disease within ten days to two weeks. Chicken- 
pox is usually free from complications, but great care 
should nevertheless be exercised by the mother or 
nurse that the child does not take cold during the 
course of the disease. The crusts in falling off some- 
times leave small pits. The child should not mingle 
with other children until the skin is clear. 



ADENOIDS. 



Adenoids are small, spongelike growths that 
are sometimes found in the vault of the pharynx — 
up, as it were, behind the nose. It is surprising in 
what a large number of children these growths are 
observed. In the causation of adenoids heredity is 
an important factor, and many children in the same 
family are often found to possess them. Thumb- 



122 THE PRACTICAL CARE OF THE BABY. 

sucking and the continuous use of the pacifier are 
said by some to be the cause of these growths. 

A child with adenoid growths catches cold 
easily, has a running from the nose a great deal of 
the time, snores, breathes to a great extent through 
the mouth, has a foul breath, and oftentimes com- 
plains of earache. A persistent cough — worse at 
night — may be the only symptom. Bedwetting and 
even convulsions are attributed to the presence of 
adenoids. 

If a child present any of the above symptoms, he 
should be examined by the family physician with a 
view to ascertaining if these growths are present. 

The handle of a spoon is placed between the 
child's back teeth, and his arms firmly held ; the index 
finger of the physician's examining hand is carried 
well up behind the soft palate. If adenoids be pres- 
ent, the finger will run up against a soft, boggy mass, 
which bleeds easily. An examination for adenoids 
usually excites a cough, which is another point in 
favor of the presence of these growths. Having once 
found adenoids in the throat of a child, they should be 
removed. No sprays, douches, or medication of any 
kind will ever remove them. They are removed 
easily by the physician with absolutely no danger to 
the child. 



COLD IN THE HEAD. 

Cold in the head, or "snuffles," usually means 
that the child had been overheated, his skin had per- 
spired, and then a draught of cold air had struck his 



DIPHTHERIA. 123 

moist skin, and he took cold. This taking cold is 
manifested in the little patient by a running nose, 
watery eyes, and a slight hoarseness. 

Playing on the floor, going out bundled with too 
much clothing, steam-heated rooms while sleeping, 
etc., are the most frequent causes of colds in the 
head. A child, when he shows the first symptoms of 
having taken cold, should be given a dose of castor- 
oil. A few drops of liquid vaselin dropped in each 
nostril by means of a medicine dropper three times a 
day will often do much to cure a cold in the head. 

A cold should never be neglected, as oftentimes 
the most dangerous diseases are ushered in by a cold 
in the head. 



DIPHTHERIA. 



Diphtheria is caused by the diphtheria (Klebs- 
Loeffier) bacillus. Diphtheria is one of the most 
contagious diseases that we have, and attacks both 
old and young. There are several varieties of the 
disease, depending upon the location of the diph- 
theria membrane. We have laryngeal diphtheria 
when the membrane forms in the larynx (see "True 
Croup''). We have nasal diphtheria when the mem- 
brane extends up into the nose. We have faucial 
diphtheria when the membrane affects the throat, 
spreading over tonsils or soft palate, or both. 

When a child has a sore throat or any difficulty 
in swallowing or difficulty in breathing, send for a 
physician at once. I have seen the worst cases of 
laryngeal diphtheria in children whose parents con- 



124 THE PRACTICAL CARE OF THE BABY. 

suited me for a "running nose" or tonsillitis. The 
symptoms of diphtheria vary in each individual. 
Some children do not seem ill at all, and yet they 
have a temperature of 102° to 104° F. and patches in 
their throats ; other children are greatly prostrated 
by the first invasion of this disease, although the 
fever may not be over 100° or 101° F. 

We have then usually fever, more or less pros- 
tration (according to the resistance of the child to 
the infection), sometimes vomiting (or, in very young 
infants, a convulsion), sore throat, or "running nose," 
inability to swallow, and some difficulty of respira- 
tion. 

An examination of the throat reveals the pres- 
ence of a grayish-white patch on one or both tonsils 
or the soft palate. The glands of the neck are usually 
swollen. If a culture from the throat be taken by 
the physician, he will find it loaded with the diph- 
theria bacilli. 

The child should be immediately isolated, a good 
dose of castor-oil given, and the physician sum- 
moned at once. There is but one treatment of diph- 
theria, and that is the immediate and fearless use of 
diphtheria antitoxin, injected under the child's skin 
by the physician. From the countless number of 
successful cases treated by antitoxin, thus reducing 
the mortality of this formerly dreaded disease from 
65 per cent, to 25 per cent., it seems to me that any 
person who is of so foolish a nature that he refuses 
to allow the physician to inject antitoxin really ought 
never to have had children ! I will not treat a case of 
diphtheria unless antitoxin is employed; it is harm- 
less. 



croup. 125 



CROUP. 

There are two kinds of croup : — ■ 

1. True croup. 2. False croup. 

1. True Croup means the formation of a mem- 
brane in the larynx. This is the so-called diphthe- 
ritic croup. True croup means that the child has 
diphtheria of the larynx and that the diphtheria mem- 
brane has formed in the larynx. (The larynx is the 
so-called "Adam's apple.") 

2. False Croup means that the child has a 
catarrhal inflammation of the larynx; this has 
nothing whatever to do with diphtheria. 

Unfortunately both of these two forms of croup 
(true and false) may commence in the same way — 
with cough, hoarseness, and slight fever. They 
may also begin with apparently no warning: the 
child awakens in the early hours of the morning with 
a hoarse, brassy cough, which, if once heard, never is 
forgotten. The true, or diphtheritic, croup is apt to 
come on more gradually than the catarrhal form. 

What can the mother or nurse do, then, for a child 
with croup, no matter whether true or false? She 
should send for a physician. She should give the 
child a teaspoonful of the syrup of ipecac every fif- 
teen minutes until he vomits. It is wise to quaran- 
tine the child until the physician is sure that the case 
is not one of true diphtheritic croup. A croup- 
kettle should be in every household ; they can be 
purchased from any good druggist and consist of a 
pail with a long tin spout and an alcohol-lamp. The 



126 THE PRACTICAL CARE OF THE BABY. 

pail is filled half full of water, the lamp is lighted, and 
the spout is placed under a sheet used like a tent over 
the child's crib. This steaming is continued at inter- 
vals of an hour or two until the attack has disap- 
peared. There is but one treatment for the true, or 
diphtheritic, form of croup, and that is the immediate 
administration of diphtheria antitoxin by the physi- 
cian. 



WHOOPING COUGH. 

Very little is definitely known of the origin of 
whooping-cough, although the ancient Greeks are 
said to have recognized the disease. In the year 
1791 epidemics of whooping-cough occurred in Den- 
mark, Norway, and Sweden. In Ireland it ranked 
fifth among the causes of death. The cause of 
whooping-cough has never been determined; it is 
most probably caused by a germ. 

Period of Incubation. — The insidious onset of 
whooping-cough makes the incubation period a very 
elastic one. Some authors assert that only a few 
days elapse between exposure and the first manifesta- 
tion of the catarrhal stage, while other authorities 
hold that the period is as long as from ten to eighteen 
days. If, after an exposure, sixteen days have 
elapsed without a cough, Dr. Holt thinks that there is 
very little danger of the disease having been con- 
tracted. It is probable that a certain varying resist- 
ance of the body to the infection is present in each 
individual, and that this is the reason of the broad 
limitations of the incubation period. Two children 
will be exposed to the disease and one be taken with 



WHOOPING-COUGH. 127 

it in seven days, while the other child will not be 
attacked with it for fourteen clays. Why? They 
were exposed to the same source of infection ! The 
answer is that the second child was not as "suscep- 
tible" to the germ ; his condition possibly was better 
and his "resistance" was greater. 

Period of Infection. — Whooping-cough may 
be communicated from the commencement of the ca- 
tarrhal stage to a period about two weeks after the 
spasmodic or whooping stage has ceased. 

Mode of Infection. — The usual source of con- 
tagion is the patient. A very brief exposure in con- 
tact with or near the patient is sufficient to contract 
the disease. A third person rarely takes the disease 
unless exposed to a person who has come directly 
from the patient without change of clothing. It is 
very rare for whooping-cough to be spread by means 
of an infected room or clothing, as occurs in the case 
of measles or scarlet fever. It is undoubtedly the 
sputum and nasal secretion which are the dissem- 
inators of infection. 

Predisposition. — Whooping-cough is essen- 
tially a disease of childhood, although there are au- 
thentic cases of adults contracting the disease. In 
adult life it is apt to run a mild course. Quoting from 
statistics at Budapest, compiled from the records of 
one clinic for thirty-four years, and giving the ages of 
the 4591 patients treated, we have the following: — 

Under 1 year 1028 

1 to 2 years 1008 

2 to 3 years 659 

3 to 4 years 904 

4 to 7 years 803 

Over 7 years 189 



128 THE PRACTICAL CARE OF THE BABY. 

Young infants are very frequently attacked and 
the disease is one of the most to be dreaded among 
this class of patients. The percentage of cases 
occurring in babies under six months of age is small, 
and nurslings are less commonly attacked. Immu- 
nity is usually insured by having had one attack; 
hence the rarity of whooping-cough during the later 
years of life. 

The disease is most prevalent during the winter 
and spring months, and is more frequently seen in 
girls than in boys. It seems to be of a more severe 
nature in the female sex. The susceptibility to 
whooping-cough is very great, it being second only 
to that of measles. It is seen to flourish in asylums, 
schools, etc., where a crowded state exists, and also 
where an unhygienic condition prevails. 

Symptoms. — Most writers recognize three 
stages in whooping-cough; each stage has its own 
symptoms : — 

1. The catarrhal stage. 2. The spasmodic stage. 

3. The stage of decline. 

The Catarrhal Stage. — The child seems to have 
an ordinary cold in the head, a coryza, accompanied 
by a short, dry, hacking cough. He feels well, eats 
well, and would sleep well were it not for his cough, 
which is usually worse at night. Or, on the other 
hand, the child may be slightly "out of sorts," have 
slight loss of appetite, and be peevish. There may 
be slight fever — possibly a degree or two. Some 
children whoop from the very beginning of the dis- 
ease. We have, then, in the catarrhal stage, a dry, 
intractable cough that nothing seems to help. This 



WHOOPING-COUGH. 129 

cough now gradually becomes more and more 
paroxysmal in character and soon enters the 

Spasmodic Stage. — This stage dates from the 
first appearance of the whoop. The paroxysm com- 
mences with from five to twenty short, explosive 
coughs of increasing intensity, followed by a long- 
drawn inspiratory effort as the air is drawn into the 
lungs ; this produces the characteristic whoop. 

The child may have four or five of these fits fol- 
lowing each other in quick succession until the plug 
of mucus is expelled; when these paroxysms are 
over the patient is usually worn out. These attacks 
often end with vomiting. There may be from five 
to sixty such paroxysms during twenty-four hours. 
During these fits the child's face becomes dusky red 
and cyanosed; the eyes are swollen and watery, and 
there may occur extravasations of blood into the 
eyes. Nosebleed is often seen. There may be at 
times a slight elevation of temperature. When the 
child feels these paroxysms approaching, he drops 
his toys and runs to his mother or nurse for support, 
or grabs any firm structure that happens to be near 
him. In severe paroxysms vomiting is frequent. 
Crying brings on an attack. 

In young infants the paroxysms are often fol- 
lowed by convulsions. The paroxysms are more apt 
to occur at night than in the daytime, and are more 
frequent in a warm, stuffy room than in the open air. 
Oftentimes no whoop occurs, but the baby coughs 
until he is almost asphyxiated. The plug of laryn- 
geal mucus is undoubtedly the irritating cause of the 
paroxysm. The spasmodic stage usually lasts from 
four to six weeks, and it is somewhat longer during 



130 THE PRACTICAL CARE OF THE BABY. 

the winter months. The whoop ceases and the dis- 
ease enters the 

Stage of Decline. — This stage consists of a simple 
bronchitis and lasts about one month ; it may be 
protracted during the winter months. 

Cases of whooping-cough occurring in the sum- 
mer are very liable to be accompanied by diarrhoea; 
cases of whooping-cough which occur during the 
winter months often have a complication of a pneu- 
monia. 

Regarding the treatment of whooping-cough, a 
great deal may be clone to modify or lessen the sever- 
ity of the paroxysms. Nearly all cases of this dis- 
ease do best when kept in the open air. In the 
nursery at night good ventilation must be main- 
tained. If it is possible, it is wise frequently to 
change the sleeping rooms of children suffering with 
whooping-cough, and also to change their bedding, 
as reinfection may take place and a short attack 
become prolonged. The food should be weakened, 
and in older children the diet should be fluid. The 
bowels should be kept regular. 

The author has used an elastic abdominal belt to 
control the vomiting of whooping-cough, and has 
found that this treatment seems to have a marked 
beneficial influence also upon the character of the 
paroxysms; this belt should be applied by the phy- 
sician. Children suffering from this distressing dis- 
ease should be under the care of their physician, as 
much may be done to alleviate the sufferings of these 
little patients. 



TONSILLITIS. 131 



TONSILLITIS. 

Tonsillitis is an acute inflammation of one or 
both tonsils. The disease occurs quite frequently in 
childhood. Some of the predisposing causes of ton- 
sillitis are heredity, scrofula, rheumatism, lowered 
vitality, and changes in the weather. The direct 
cause of tonsillitis is usually taking cold. The child 
feels out of sorts, has a fever (103° to 105° F.), 
sore throat, headache, and backache. Pain on swal- 
lowing is very marked, but is not always a constant 
symptom. There is foul breath and usually more or 
less thickness of speech. In infants the fever and 
inability to nurse may be the only noticeable symp- 
toms. Upon examination of the throat we find either 
one or both tonsils red and swollen ; there may be 
from three to twelve small, white spots scattered 
over the surface of the affected tonsil or tonsils. 
Abscesses sometimes form about the tonsils, and we 
then have a condition of quinsy. 

A child with tonsillitis should be kept away from 
other children, first, because tonsillitis is mildly con- 
tagious, and, second, because cases of diphtheria and 
scarlet fever may be mistaken for tonsillitis. 

Give the child a dose of castor-oil, place cloths 
wrung out in cold water about his neck, and give him 
a light fluid diet. If in a very young baby, dilute his 
food one-half. Send at once for the physician. A 
child that has frequent attacks of tonsillitis is bene- 
fited by having his enlarged tonsils removed. There 
is practically no danger from this operation when 
performed by skilled hands. 



132 THE PRACTICAL CARE OF THE BABY. 



MUMPS. 

Mumps is a contagious disease, and mani- 
fests itself by a swelling of one or both parotid 
glands. These glands are situated on either side of 
the face in front of and below the ear. The incuba- 
tion period of mumps (time from exposure to first 
symptoms) varies from five to twenty days. The 
child is peevish, has a loss of appetite, and soon com- 
plains of pain on opening the mouth. One or both 
sides of the face begins to swell, and oftentimes the 
swelling extends down on to the neck. In very young- 
children convulsions may occur. 

The ovaries and breasts in the female and the 
testicles in the male are often affected by mumps ; 
hence care should be exercised that the patient be 
kept quiet. Keep the child on a fluid diet and keep 
the bowels open. 



BRONCHITIS. 

Bronchitis is an inflammation of the small air- 
tubes situated throughout the lungs. A child catches 
cold, his nose runs, his throat becomes slightly red ; 
gradually this inflammation continues down the 
windpipe and spreads through the air-tubes in the 
lungs. A rattling is heard each time the child 
breathes, and may be felt by placing the hands 
on the child's chest; this rattling, or "drawing," as 
some mothers call it, is produced by the products of 
inflammation having caused an increase of mucous 



PNEUMONIA. 133 

secretion in the air-tubes, and each time the child 
breathes the air has to pass through this mucus. 
The predisposing cause of bronchitis is too much 
clothing on the child either when he is out of doors 
or when he is sleeping in his crib at night. It is the 
rule rather than the exception to overclothe children. 
Steam heat in rooms is another great factor in the 
causation of bronchitis. A well child should sleep in 
a room with the heat always turned off at night. The 
temperature of the sleeping room should never be 
above 68° F. 

As cases of pneumonia are frequently mistaken 
by the mother or nurse for bronchitis, the physician 
should be consulted when the first sign of bronchitis 
manifests itself. The child should be given a dose of 
castor-oil and should be placed upon a light diet. 
Mustard should be applied to the chest in the form 
of a large home-made mustard plaster; this plaster 
is made by mixing 1 part of ground mustard with 3 
parts of flour. Allow the mustard plaster to remain 
on the child from ten to fifteen minutes three times 
a day. 



PNEUMONIA. 



Pneumonia is an inflammation of the lungs, and 
is a very serious disease in children. In infants its 
death-rate is extremely high. It occurs independ- 
ently or as a complication of other diseases. The 
inflammation may be of the lung-tissue itself and 
affect one or more lobes of the lungs ; this form is 
called lobar pneumonia. The inflammation may 



134 THE PRACTICAL CARE OF THE BABY. 

affect the air-tubes scattered throughout the lungs, 
accompanied by a slight infiltration of the lung-tissue 
itself along the lines of these air-tubes (or bronchi) ; 
in this latter case we have what is termed a broncho- 
pneumonia, and it is this form that is by far the most 
common in children. 

Lobar pneumonia usually comes on suddenly ; 
broncho-pneumonia develops gradually. A child 
with pneumonia breathes rapidly, the nostrils open 
and close slightly at every breath, and there is a 
slight grunt or sigh at each expiratory effort ; this 
sigh is called the "pneumonic sigh" and is very char- 
acteristic of the disease. The fever may range from 
100° to 105° F. 

A child with pneumonia should be dressed with 
as few clothes as possible ; a band, a light shirt, and 
night-drawers (or night-gown) should constitute his 
apparel. He should be placed in a large, airy room, 
the temperature of which should be about 70° F. He 
should be allowed plenty of fresh air by frequently 
airing the sickroom and by the use of the window- 
board (see page 144). His food should be diluted 
one-half or to one-fourth its former strength ; if the 
patient be an older child, his diet should be liquid. 
The application of a large mustard plaster to the 
affected side of the chest, or to the entire chest if 
necessary, is all that the mother or nurse should do. 
This mustard plaster is made by using 1 part of 
mustard to 3 parts of flour ; it should be applied three 
times a day, for fifteen minutes at a time. Keep the 
child's bowels open by an occasional dose of castor- 
oil. The remainder of the treatment should be left 
to the physician. 



MALNUTRITION. 135 



MALNUTRITION (MARASMUS). 

Malnutrition means bad nutrition. It is usually 
the result of improper feeding, and occurs most fre- 
quently in bottle-fed babies. They are not started 
right, or else they get off the track as regards proper 
food after having been started right. The usual his- 
tory of a case of malnutrition is as follows : A baby 
is born into the world a nice, healthy, seven- to ten- 
pound normal infant. The mother nurses her off- 
spring for a few weeks and all goes well; then on 
account of the lack of breast-milk supply or the 
formation of an abscess in the mother's breast, or on 
account of some other reason, the baby is taken 
from the breast and put upon a mixture of condensed 
milk and water. In using condensed milk I have 
found that mothers are prone to make the mixture 
too weak; the baby gets on well enough for a short 
time, and then the mother says that the condensed 
milk does not agree with the baby; so she changes 
her infant's diet to one of cows' milk diluted with 
water. Just as she made the condensed-milk mix- 
ture too weak, she now makes the cows'-milk mixture 
too strong, and baby vomits, he has the colic, he is 
constipated, or he may have diarrhoea. The cows' 
milk is likewise thrown aside, as the mother says that 
it also does not agree with her baby, and now comes a 
lightning change in the food line from one patent 
food to another, all with practically the same result, 
namely: that nothing agrees with the baby! The 
mother now has a baby on her hands that weighs less 
than he did when born, he vomits, he will not take his 



136 THE PRACTICAL CARE OF THE BABY. 

food (and no wonder, for he is disgusted with the 
stuff that has been fed him for the past two or four 
months !), he has attacks of constipation alternating 
with diarrhoea, he has colic, his flesh is wasted away 
and flabby, and in extreme cases he has the face of 
an old man. This extreme condition is called maras- 
mus. All in all, such a baby is a very poor specimen 
of the human race. 

What should be done, then, with a baby suffering 
from malnutrition ? In the first place, a child should 
never be allowed to get in such a condition. An 
infant should never be taken from the breast except 
upon a physician's advice. A baby's food should 
never be changed except upon the advice of a phy- 
sician. The rational feeding of bottle-fed babies is 
not the simple problem that the majority of the laity 
seem to regard it. It is at the best a hard proposi- 
tion, as each baby is a law unto himself and requires 
the skill of the physician to tide him over babyhood. 
I therefore beg of you, mothers and nurses, do not 
tamper with, nor juggle, nor experiment on your 
own account with your baby's nourishment. It is 
his life, and you have no business to trifle with it. 

Secondly, given a baby that presents the symp- 
toms of malnutrition, zvhat shall zve do with him? He 
should be unconditionally surrendered to the care of 
the physician, who will look after his feeding, and in 
all probability will start him off on some weak food 
mixture and then gradually strengthen his food as 
fast as the digestive powers of the individual baby 
will permit. Such a child should have a salt-water 
bath morning and evening (see "Brine Bath"). He 
should have a tablespoonful of goose-grease or 



RICKETS. 137 

sweet-oil rubbed into his skin every morning and 
evening after his bath. He should be disturbed by 
handling as little as possible. His extremities should 
be kept warm by the use of the hot-water bottle. He 
should have an abundance of fresh air. His road to 
health will be a long one. If he is in an extreme 
condition of marasmus, it is a question whether he 
can be cured at all ; but astonishing results have been 
observed to follow the above line of treatment in 
many of these severe cases. 



RICKETS 



Rickets is one of the diseases caused by im- 
proper feeding and is commonly seen in bottle-fed 
babies. This disease affects nearly every tissue in 
the body, causing a deformity of the bones. We 
have all seen these rickety babies with square-shaped 
heads, open fontanelles at two years, large abdo- 
mens, bowlegs, late teeth, enlargement of the ends 
of the bones that form the wrist- and ankle- joints, 
and small, round, bony enlargements on the ribs, 
constituting what is known as the "rosary." These 
babies begin walking late in life, and are subject to all 
kinds of disorders. Rickets is usually caused by giv- 
ing a baby too strong a milk mixture at the begin- 
ning; his stomach rebels, and then begins the era of 
improper feeding, trying one food after another, with 
the same bad result. A baby that is fed upon too 
weak a food for a long time will soon begin to show 
signs of rickets. 

A baby showing the first symptoms of rickets 



138 THE PRACTICAL CARE OF THE BABY. 

should be at once seen by the physician. The child 
should have fresh air, good hygienic surroundings, 
and an entire change of food. 



SCURVY. 



Scurvy is a constitutional disease and it indi- 
cates imperfect nutrition. A prolonged diet of ster- 
ilized milk is said by some to be a factor in the 
causation of this disease. Scurvy is caused by some 
prolonged error in diet, such as a prolonged diet of 
condensed milk or proprietary foods. It is seldom 
seen in nursing infants. A child suffering from 
scurvy usually has a pale skin; he has sore gums, 
which are swollen, spongy, and bleed easily. There 
is usually pain in the joints, and therefore the child 
cries when he is handled. The joints may be swollen, 
especially the ankle and knee. 

Small hemorrhages occurring under the skin 
are often seen. Scurvy is mistaken in its first stages 
for rheumatism, but rheumatism in a baby under two 
years of age is an almost-unheard-of affection. 
When a child exhibits symptoms of scurvy, he should 
be put upon a radical change of food at once. He 
should be given the juice of an orange every day. If 
sierilized or pasteurized milk has been used as a diet 
for a prolonged time, stop it at once and give the 
child fresh, uncooked cows' milk. Give the baby 
fresh beef-juice every other day. Scurvy is a disease 
in which improvement begins immediately upon the 
commencement of proper treatment. 



CIRCUMCISION HIVES. 130 



CIRCUMCISION. 

It very frequently happens that the foreskin is 
too long or that the opening in it is insufficient to 
allow it to easily slip back and forth over the glans. 
This condition gives rise to many symptoms in the 
child, such as bedwetting, extreme nervousness, bad 
habits, and skin eruptions, especially about the face. 

When this opening in the foreskin is of fair size 
it may be stretched by the physician and the adhe- 
sions broken up ; it should then be kept well greased 
with boric acid ointment night and morning, and the 
foreskin worked back and forth over the glans twice 
daily. By this means circumcision may be avoided. 
When the opening is only of pin-head size, nothing 
will do but a complete circumcision. This little opera- 
tion should be done as soon as possible — any time 
after the baby is a month old. It may become neces- 
sary to circumcise a baby almost as soon as it is born, 
and if done by a physician no harm ever results from 
the operation ; in fact, the harm is done by allowing 
this constricted condition to remain. 



HIVES. 

Hives is an acute inflammation of the skin and 
is characterized by white or pinkish wheals (solid 
or semisolid elevations) scattered over the body, ac- 
companied by intense itching. These elevated spots 
will appear suddenly, and oftentimes leave as sud- 
denly as they came. The spots are from the size of a 



140 THE PRACTICAL CARE OF THE BABY. 

small pea to t*he size of one's fingernail. Local irri- 
tation of any kind may cause an appearance of the 
eruption." Stomach or bowel irritation caused by 
improper food is the usual cause of hives. Certain 
kinds of food may bring on an attack. A child with 
hives should be dressed coolly, a bran bath given 
twice daily, and his bowels cleared by a dose of 
castor-oil. His food should be weakened for a time. 
He should be kept free from excitement and out of 
the sun. 



ECZEflA. 

Eczema is an inflammation of the skin that is 
characterized by redness, papules, vesicles, or pus- 
tules. It is accompanied usually by intense itch- 
ing. It is easily confounded with other diseases, 
such as scarlet fever, measles, and chicken-pox. The 
usual site of eczema in children is upon the scalp and 
face. The most frequent cause of eczema is some 
error in diet; a milk mixture that is too strong will 
very soon bring out a crop of eczema ; or a food which 
is too weak will cause the same condition. 

Teething never causes eczema. Unseasonable 
weather, irritating soaps, rough underclothing, and 
hot, damp days, all are causes of eczema. 

I have seen cases of eczema in which a con- 
stricted state of the foreskin existed, and upon cir- 
cumcision the eczema entirely disappeared. A child 
with eczema should be placed under the supervision 
of a physician and all errors of diet corrected. The 
child should wear loose, comfortable, nonirritating 
clothing, and should never be overclothed. 



SWOLLEN GLANDS. 141 

If the eczema is on the body the child should be 
given a bran bath morning and evening (see "Bran 
Bath"). See that the child rests and sleeps well and 
give him no undue excitement. Use good Castile 
soap in washing the baby, and see that every vestige 
of soap is rinsed from the baby's skin after the bath. 
Do not use a water for bathing that is too hard. In 
children with susceptible skins a veil is to be worn to 
protect them from the wind. The parts affected 
should be kept as dry as possible. When eczema 
occurs in a nursing baby the cause will be found in 
some error in the diet of the mother — too much tea, 
for instance, or chronic constipation. 

The main point to be remembered in the treat- 
ment of eczema is the fact that it is errors in diet and 
mode of living that are to be rectified, rather than to 
try to effect a cure by the application of ointments 
and lotions to the child's skin. 



SWOLLEN GLANDS. 

Swollen or enlarged glands are caused either 
by an acute inflammation in or near them or else 
by some chronic and long-standing inflammatory 
process. Take, for example, a child with diphtheria, 
with large, swollen glands on either side of the neck 
and at the angle of the jaw; these glands are swollen 
because they take up and absorb the poison manu- 
factured by the diphtheria bacillus. This enlarge- 
ment decreases with convalescence, and thus we have 
an example of acute glandular enlargement. 



142 THE PRACTICAL CARE OF THE BABY. 

On the other hand, take, for example, a child 
that is weak and delicate and becomes infected with 
the bacillus of consumption ; we notice here that the 
glands gradually enlarge over a space of time of per- 
haps months. If these glands are left to themselves 
they will break down and form abscesses, which are 
usually tubercular. Here we have an example of 
chronic glandular enlargement. The glands in the 
armpit or in the groin may become acutely enlarged 
from some wound on the hand or the foot. The en- 
largement of the parotid gland situated under and in 
front of the ear, due to mumps, must not be forgot- 
ten (see "Mumps"). In cases of acute glandular en- 
largement due to the absorption of some poisonous 
matter from the neighborhood of the gland, we must 
treat the cause of the swelling, and not the gland itself. 

Head-lice will cause swelling of the glands of the 
neck; remove the head-lice and the swollen glands 
will disappear. Swollen glands, no matter whether 
they are acute or chronic, demand the attention of 
the physician, as usually by his care a speedy diminu- 
tion in their size will be effected. 



BEDWETTINQ. 



Bedwetting is encountered both in very young 
and in older children. It is usually a nervous dis- 
order, although it may be observed in children who 
do not seem to be of a nervous temperament. I 
have seen several cases where circumcision entirely 
relieved the condition. A child who is a bedwetter 
should be given no fluid after 5 o'clock in the after- 



HEAD-LICE WORMS. 113 

noon. He should be prevented from sleeping on his 
back; this may be accomplished by tying a towel 
with a knot in it about the patient in. such a manner 
that the knot will come in the middle of the child's 
back. If these procedures do not help the affection, 
the treatment should be left in the hands of the 
physician. 



HEAD=LICE. 

Head-lice are commonly seen in the hair of chil- 
dren of the lower classes, and oftentimes from con- 
tact we find them in the heads of the children of the 
well-to-do. 

The nits (or eggs) are seen in the hair as small 
white specks, glued on, as it were, to the individual 
hairs. There is itching and occasionally crusts will 
be noticed. There may be enlargement of the 
glands of the neck. 

The treatment of head-lice consists of cutting 
the hair short and applying a mixture of 1 / 2 kerosene 
and 1 / 2 olive-oil to the scalp morning and night. 
The child should have a soap-and-water shampoo 
once daily. 



woRns. 

There are three kinds of worms which may affect 
children : they are the tapeworm, the roundworm, 
and the pinworm (or threadworm). The tapeworm 
and the roundworm live in the intestines of the 
child. The pinworm makes his home in the rectum 
of the child, and oftentimes migrates into the 



144 THE PRACTICAL CARE OF THE BABY. 

vagina of girls and into the foreskin and urethra of 
boys, causing an inflammation of these parts. The 
symptoms of worms are said to be numerous ; in fact, 
the only way that one can be sure that a child has 
worms is when you see the worms or pieces of them 
in the child's stools. 

Pinworms may be found around the anus. 
When a female child has an itching of the vagina ac- 
companied by a whitish discharge, or when a male 
child has a similar condition of the prepuce, worms 
should be thought of and looked for. 

The treatment consists in removing the worms ; 
this treatment must be left to the physician. 



THE NURSERY. 



The room selected as the nursery should be a 
well-ventilated, dry room with an abundance of good 
air and sunlight. This room should be, if possible, 
above the first floor of the house, as upstairs rooms 
make better nurseries than do rooms on the ground 
floor. Good ventilation is of prime importance, and 
for this reason one window should be open some- 
what most of the time. When the weather is very 
cold, this ventilation may be accomplished by the use 
of a window-board. This window-board is a board 
about four or five inches wide and of a length corre- 
sponding to the width of the window. The window 
is raised, the board is placed in position, and the win- 
dow is closed upon this board ; there remains a space 
where the two sashes meet equal to the width of the 



THE WETNURSE. 145 

window-board. Through this space the fresh air 
enters the room and by this means ventilation is 
maintained, but there is no draught. 

When baby is out of the nursery, the room 
should be aired. The temperature of the nursery 
should never rise to above 70° F. During the night, 
while baby is asleep, the temperature may go as low 
as 65° F. A child sleeps best in a moderately cool 
room. Avoid all draughts in the nursery. A screen 
is very useful in the nursery to stand in front of an 
open window and protect the baby from a draught. 
Plain painted walls, a hard-wood floor covered with 
rugs, and a few wooden chairs not upholstered make 
the best furnishings. There should be no plumbing 
of any kind in the nursery. Soiled napkins or soiled 
clothes should not be hung in the nursery. Steam 
heat or gas should not be used to heat the nursery; 
a hot-air furnace, an open fire, or a Franklin stove 
are the best means of heating this room. There 
should be a good, reliable thermometer hanging in 
every nursery; it should be hung about four feet 
from the floor. 



THE WETNURSE. 

When it is impossible for a mother to nurse her 
baby, if he is prematurely born, if he is delicate, and 
if cows' milk has been thoroughly and correctly tried 
and found to be of no avail, then a wetnurse is of 
service. It is, however, very rare to find a baby that 
will not get along when properly fed upon cows' 
milk. 

10 



146 THE PRACTICAL CARE OF THE BABY. 

By employing a wetnurse the baby will have the 
advantage of getting human milk. There are dis- 
advantages, however, in employing a wetnurse : first, 
good wetnurses are hard to obtain and usually ex- 
pensive ; and, secondly, oftentimes diseases — such as 
syphilis and tuberculosis — are transmitted to the 
baby by means of the wetnurse. In selecting a wet- 
nurse she should be carefully examined by the phy- 
sician to see that she is free from disease. A wet- 
nurse should be between the ages of twenty and 
thirty years. Blondes make better nurses than do 
brunettes. German women make the best wet- 
nurses. 

The age of the wetnurse's child should be about 
the same as that of the baby that she is to nurse. 
Before employing a wetnurse her breast-milk should 
be analyzed to see that it is of the proper composi- 
tion. The wetnurse should be a woman of quiet 
temperament, not easily made irritable, and in good 
health. 

The diet of a wetnurse should be the same as 
that of a nursing mother (which see). She should 
have out-of-door exercise and plenty of fresh air. 

A wetnurse is employed to suckle a baby, and 
therefore she should not be overworked by other 
duties ; on the other hand, she should not be kept in 
a state of idleness, as she will then become consti- 
pated, and consequently the baby will suffer. 



BAD HABITS. 147 



BAD HABITS. 



Sucking. — This habit consists in sucking some 
portion of the infant's own body, usually the fingers, 
thumb, or toes. The baby often sucks a part of his 
clothing or a rubber nipple. The sucking habit is a 
difficult one to break, as it often persists even until the 
child is from three to six years old. Deformities of 
the fingers, thumb, or lips may result from this habit. 
A baby should never be given any object to suck, 
such as the "pacifier" or rubber nipple. Restraint is 
the only remedy. A baby who sucks his hands 
should wear mittens, especially at night. Tying the 
hands together with a piece of tape, which is carried 
around behind the baby's back, thus making it im- 
possible for him to get his hands to his mouth, is 
often successful in breaking baby of this habit. 

Masturbation (Leg-rubbixg). — Masturbation 
consists in rubbing the genitals. In the male, an 
elongated prepuce may be the cause, and circumci- 
sion will usually remedy it. Masturbators are usu- 
ally white-looking children, with sunken, sleepless 
eyes ; they become absent-minded and complain of 
headaches. If masturbation is caused by rubbing 
the genitals, restrain the hands so that they cannot 
reach these parts (see "Sucking"). If masturbation is 
caused by leg-rubbing, separate the child's thighs by 
a large diaper, so that they cannot rub together. 
The physician should be consulted. 

Ear-pullixg. — Often babies seem to enjoy pull- 
ing their own ears and many an ear has been disfig- 
ured by this habit. Bandaging the hands, so that 
the child cannot grasp the ear, is the treatment. 



148 THE PRACTICAL CARE OF THE BABY. 



FOOD RECIPES. 

Junket (Curds). 

Take 1 / 2 pint of fresh milk, heat it lukewarm 
(very slightly warm), add 1 teaspoonful of Fairchild's 
essence of pepsin, and stir just enough to mix. Let 
it stand until firmly curdled. It may be served plain 
or with sugar. 

Whey. 

Take 1 / 2 pint of fresh milk, heat it lukewarm 
(very slightly warm), add 1 teaspoonful of Fairchild's 
essence of pepsin, and stir just enough to mix. Let 
it stand until firmly curdled. Now beat it up with a 
fork until the curd is finely divided, and strain through 
a piece of muslin. The whey is then ready for use. 

Peptonized Milk. 

Contents of 1 peptonizing tube (manufactured by 
Fairchild Bros. & Foster). 

Water (cold) 1 teacupful. 

Milk (fresh and cold) 1 pint. 

Put the powder contained in the tube into a clean 
quart bottle, add the cold water, and shake well ; 
then pour in the milk and again shake the mixture 
thoroughly. Place the bottle in water of about 115° 
F. (or as hot as the whole hand can be held in it 
for one minute without discomfort) and keep the bot- 
tle there for twenty minutes. Have the water come 
up on the sides of the bottle to above the level of the 



FOOD RECIPES. 149 

milk in the bottle. Now take the bottle out of the 
warm water and place it immediately on ice. Pep- 
tonized milk should have a slightly bitter taste ; this 
bitter taste may be overcome to some extent by the 
addition of sugar. 

Albumin-water. 

Cold water 1 / 2 pint. 

White of 1 fresh egg. 

Salt a pinch. 

Brandy 1 teaspoonful. 

Mix the white of the egg -with the water, then 
add the brandy and finally the salt ; shake thoroughly. 
It should be given to the baby cold, either from the 
bottle or from a spoon. 

Barley-water. 

Robinson's prepared barley-flour, 

1 level tablespoonful. 

Water (boiling) 1 pint. 

Salt a pinch. 

The flour should be stirred up with a little cold 
water before adding the boiling water. Let it boil for 
twenty minutes, strain through a fine strainer, and 
add enough boiling water to bring the quantity again 
up to one pint. 

Barley-gruel. 

Made the same as barley-water, but use tzvo good 
tablespoonfuls of Robinson's prepared barley-flour. 



150 the practical care of the baby. 
Oatmeal-water. 

Oatmeal 3 tablespoonfuls. 

Cold water 1 quart. 

Salt a pinch. 

Wash the oatmeal thoroughly. Cook in a dou- 
ble boiler for two hours down to one pint, adding a 
little boiling water from time to time. Strain through 
muslin. When strained, add enough boiling water 
to make quantity up to one quart. 

Oatmeal-gruel (Jelly). 

Oatmeal (thoroughly washed).. 3 tablespoonfuls. 

Cold water 1 quart. 

Salt a pinch. 

Cook in double boiler for two hours down to one 
pint, adding water from time to time. Strain through 
muslin. 

MlLK-TOAST. 

Milk (fresh) 1 cupful. 

Cornstarch V 2 lablespoonful. 

Butter Va tablespoonful. 

Salt a small saltspoonful. 

Scald the milk. Melt the butter in a saucepan ; 
when the butter is hot add the cornstarch and stir 
into a paste with the hot butter. Pour in the scalded 
milk slowly, and beat all the time until smooth. Let 
it boil up once ; now add the salt. Toast two slices of 
bread and pour the thickened milk over the slices. 
Let it stand five minutes; it is now ready. 



food recipes. 151 

Mutton-broth. 

Chopped mutton (with a few pieces of bone), 

generally taken from the neck 1 pound. 

Water (cold) 1 pint. 

Salt a pinch. 

Cook for three hours over a slow fire down to 
half a pint, gradually adding a little water to prevent 
burning. Strain through a fine strainer. When 
partly cool, carefully skim off all the fat. It may be 
given to the child warm or cold (in the form of jelly). 

Chicken-broth, veal-broth, and beef-broth are 
made exactly the same as mutton-broth. 

Beef-juice. 

One pound of lean round steak cut thick. Broil 
it slightly. Cut it in small pieces and squeeze out the 
juice by means of a meat-press or a lemon-squeezer. 
From two to four ounces can generally be obtained 
from a pound of meat. This juice may be given 
warm by standing the cup in warm water ; do not use 
much heat in warming the juice, as the albuminous 
part will coagulate if you do. 

Scraped Beef. 

A piece of lean round steak is very slightly 
broiled ; the browned, greasy outside portion is cut 
away ; then with a knife or fork the rare part is 
scraped or shredded. One teaspoonful to one table- 
spoonful may be given (well salted) to a child of 
eighteen months. 



INDEX 



Adenoids, 121 
Airing, 42, 108 
Albumin-water, 149 
Antitoxin in diphtheria, 124 
Appetite, loss of, 92 
Apron, creeping, 26 

Baby-talk, 36 
Bad habits, 147 
Band, flannel, 9 

woolen knit, 11 
Barley-water, 57, 149 
Basket-bed, 44 
Bassinets, 45 
Bath, 1 

bran, 4 

in summer, 4 

temperature of the, 2 

thermometer, 2 

time of the, 1 

tub, 1 
Bathing, 1 
Bed for infant, 44 

to make a, 45 
Bedwetting, 139, 142 
Beef, scraped, preparation of, 

151 
Beef -broth, preparation of, 151 
Beef-juice, 85 

in scurvy, 138 

preparation of, 151 
Belt, elastic, in whooping-cough, 
130 



Bicarbonate of soda, 114 
Blanket, pinning, 13 

for baby's bed, 46 
Bleeding from the umbilical 

cord, 113 
Boiler for nursing-bottle, 78, 79 
Boiling the nursing-bottles, 78 
Booties, 12 

Boric acid solution, 4, 7 
Bottle, author's boiler for the 
nursing-, 78, 79 

-fed baby, weaning of a, 67 

-feedings, number of, in 
twenty-four hours, 83, 
85 

the care of the nursing-, 76 

the nursing-, 75 
Bottled milk, 81 
Bowels, 47 

massage of the, 55 

position when moving, 49 

time for moving, 47, 49 
Breadpan, 80 
Breast-fed baby, weaning a, 05 

-feeding, signs of inadequate, 
64 

-milk, composition of, 82 

-pump, 63 

-shield, 62 
Breasts, swollen or caked, 62 
Bronchitis, 132 

mustard plaster in, 133 
Broncho-pneumonia, 134 

(153) 



154 



INDEX. 



Broth, mutton, 150 

beef-, 151 

chicken-, 151 

veal-, 151 
Burns, 113 

Caked breasts, 62 

Cap, 25 

Care of feedings in summer, 95 

Carrying babies, 107 

Castor-oil, 55, 57, 111 

Cereal waters in diarrhoea, 57 

Chafing, 8 

Chapin's (Dr.) dipper, 80, 93 

Chapping, 8 

almond-oil in, 8 
Chicken-broth, 151 

-pox, 116, 120 
Chill, 113 
Choking, 113 

Cholera infantum (see "Diar- 
rhoea"), 56 
Circumcision, 139 
Clothing, 9 

long clothes, 9 

night-, 23 

out-of-door, 25 

short clothes, 18 
Coat, 25 

Cold in the head, 122 
Colostrum, 61 
Condensed milk, 101 
Conical rubber nipple, 71 
Constipation, 52 

castor-oil in, 55 

in older children, 55 
Convulsions, 110 
Cotton, nonabsorbent, 80 
Cough in adenoids, 122 
Cows' milk, composition of, 82 



Cream, gravity, 94 
Creeping apron, 26 
Cribs, 45 
Croup, 125 

-kettle, 125 

true and false, 125 
Cry, 57 

condition causing a baby to, 
58 

Dentition, 39 

eruption of teeth in, 39 

management of, 40 

signs of, 40 

variations in, 40 
Development, 32 

general, 34 

of the head, 32 
Diapers (see "Napkins"), 26 
Diarrhoea, 56 

cause of, 56 

treatment of, 57 
Diet of a nursing mother, 63 

schedule, first to sixth year, 
87 
Diphtheria, 123 
Dipper, Dr. Chapin's cream, 80, 

93 
Drawers, 29 

night-, 24 
Dreams, bad, 47 
Dress, white muslin, 16, 20 
Drinking-water, 91 

Ear, foreign-bodies in the, 115 
Earache, 112 
Ear-pulling, 147 
Eating between meals, 91 
Eczema, 140 
of scalp, 9 



INDEX. 



155 



Egg-water (see "Albumin- 
water"), 149 
Elastic belt in whooping-cough, 

130 
Emergencies, 110 
Enema of soap and water, 55 

of sweet oil, 52 
English rubber nipple. 70 
Enlarged glands, 141 
Eruptive-fever chart, 116 
Exercise, 43 

Examination of the throat, 114. 
115, 117 
for adenoids, 122 
Exhaustion, a cause for crying, 

60 
Eyelids, crusted, 5 
Eyes, 4 

boric acid solution for, 4 
color of, 5 

foreign bodies in the, 112 
inflammation of the, 5 
Eye-teeth, 40 

Fat in breast-milk, 82 

in cows' milk, 82 
Feeding, care of (in summer), 
95 

correct position during bot- 
tle-, 86 

formulas (cows' milk), 83 
Feedings, preparation of, 93 
Feet, cold, 12 
Fever, 112 

chart of eruptive fevers, 116 
Fontanelles, 33 
Food recipes, 148 
Foreign bodies swallowed, 112 
Fountain syringe, 55 
Franklin stove, 145 



Frequency of bottle-feedings, 83, 

85 
Fright as a cause of crying, 60 
Funnel, glass, 81 

Gland, parotid, swelling of in 

mumps, 132 
Glands, swollen, 141 
Goose-grease in malnutrition, 

136 
Graduate, glass, 80 
Gravity cream, 94 
Growth, 32 
Gums, swollen, 40, 41 

Habits, 147 

Habitual colic, 110 

Head, development of the, 32 

Head-lice, 143 

Hearing, 36 

Height, 32 

Hives, 139 

Home - modification of cows' 

milk, 80 
Hot- water bag, 110, 112 
Hunger, a cause of crying, 58 

Ingredients of feedings for 
babies at different ages, 
83 

Injection (see "Enema"), 55 

Jaundice, 8 
Junket, 148 

Kettle, croup-, 125 
Kimono, 21 

Leggins, 25 
Leg-rubbing, 147 



156 



INDEX. 



Length, 32 

Lice, head-, 143 

Lifting babies, 103 

Lime water, 81 

Lobar pneumonia, 133 

Long coat, 25 

Loss of appetite, 92 

Malnutrition, 135 
Marasmus, 135 
Masturbation, 147 
Measles, 117 
Meconium, 50 
Midnight feeding, 85 
Milk, condensed 101 

-feeding formulas, 83 

pasteurized, 96 

pasteurized, in scurvy, 138 

peptonized, 148 

sterilized, 98 

-toast, 150 

whole, 94 
Mittens, 25 
Mixed feeding, 64 
Modification of cows' milk, 82 

home-, 80 
Mouth, 6 

boric acid solution in the, 7 

method of cleansing the, 7 
Mumps, 132 

Mustard plaster in bronchitis, 
133 
in pneumonia, 134 
preparation of, 133 
Mutton-broth, 151 

Nap (see also "Sleep*'), 47 
Napkins, 26 



Napkins (continued) 

care of, 28 

cheesecloth, 26 

cotton diaper, 26 

method of putting on, 27 

number required, 27 

size of, 27 

washing of, 28 

wet, 28 
Night-clothes, 23 

-drawers, 24 

feeding, dropping of, 85 

terrors, 47 
Nipple, care of the rubber, 73 

conical, 71 

English, 70 

flow from, 71 

other varieties of, 72 

rubber, 70 
Nipples, care of breast, 61 
Nose, foreign bodies in the, 112 
Nosebleed, 112 
Nursery, 144 

temperature of the, 145 
Nursery-chair, 50 

author's, 51 
Nursing, 61 

hours for, 61 

mother, care of, 63 
diet of, 63 

Oatmeal-gruel, preparation of, 
150 
-water, 85 

preparation of, 150 
Older children, diet of, 90, 91 
Orange-juice, 87, 89 
in scurvy, 138 



INDEX. 



157 



"Pacifier,"' the, 147 

Pad, quilted, for baby's bed, 46 

Pain as a cause of crying, 58 

Pap-spoon, 67 

Parotid gland, swelling of in 

mumps, 132 
Pasteurization, 96 
Pasteurizer, the author's, 97 
Peptonized milk, 148 
Petticoats, 14, 19 
Pillow, 46 
Pinning-blanket, 13 
Pinworms, 143 
Pitcher for feedings, 81 
Playthings, 37 
Pneumonia, 133 

broncho-, 134 

lobar, 133 

mustard plaster in, 134 
Pneumonic sigh, 134 
Preparation of the feedings, 93 
Prickly heat, 8 

Proprietary foods in scurvy, 138 
Proteids in cows' milk, 82 

in breast-milk, 82 

Quantity of feeding in twenty- 
four hours, 83-85 

Rectal tube. 55 

Regurgitation of milk, 92 

Rickets, 137 

Rocking, 46 

Roundworms, 143 

Rubber sheet for baby's bed, 46 

Sacque, flannel, 17 

worsted, 17 
Scalds, treatment of, 114 
Scales for weighing, 31 



Scalp, eczema of, 9 
Scarlet fever, 116, 119 
Scraped beef, 151 
Screen for nursery, 145 
Scurvy, 138 

orange-juice in, 138 

proprietary foods in, 138 

sterilized milk in, 138 
Shirt, 12, 13 
Shoes (see "Booties"), 12 

kid and pique, 18 
Short clothes, 18 
Sight, 35 

Signs of inadequate breast-feed- 
ing, 64 
Skin, 8 

eruptions cured by circum- 
cision, 139, 140 
Skirt (short), 20 
Sleep, 44, 46 

want of, a cause for crying, 59 
Sleeping out of doors, 42 
Slip, white muslin, 16 
Small-pox, 116 
Snuffles, 122 
Soap-stick, 49 
Soda-mint granules, 110 
Special conditions requiring 
changes in food ingre- 
dients, 92 
Sprue, 7 
Standing, 35 
Sterilization, 98 
Sterilized milk in scurvy, 138 
Stockings, 18 
Stomach-teeth, 40 
Stools, appearance of healthy, 
50 

black, 52 

brown, 52 



158 



INDEX. 



Stools (continued) 

foul, 52 

green, 51 

pasty, or claylike, 52 

variations from the normal, 
51 

white or yellow curds in, 51 
Sucking, 147 
Sugar in breast-milk, 82 

in cows' milk, 82 

of milk, 81 

-water, 83 
"Summer complaint" (see "Di- 
arrhoea"), 56 
Suppositories (rectal), 50 
Sweet-oil in malnutrition, 136 
Swollen breasts, 62 
Swollen glands, 141 

Talking, 36 

Tapeworms, 143 

Taste, 36 

Tears, 60 

Teeth, cleaning the, 7 

eruption of, 39 

first, 39 
Teething (see "Dentition"), 39 

diet in, 40 

management of, 40 

signs of, 40 
Temper, a cause of crying, 60 
Temperature, 109 

method of taking, 109 

thermometer for taking, 109 

variations of, 109 
Thermometer in nursery, 145 
Thirst, a cause of crying, 58 
Threadworms, 143 
Throat, examination of the, 
114, 115, 117 



Thrush, 7 

Tongue-tie, 7 

Tooth, to rub through a, 41 

Toothbrush, use of, 7 

Tonsillitis, 131 

Tonsils, enlargement of the, 131 

Toys, 37 

Training babies, 59, 69 

Tray for making feedings, 81 

Typhoid fever, 116 

Umbilical hemorrhage, 113 
Urine, incontinence of (see 
"Bedwetting"), 142 

Vaginitis caused by worms, 143 
Veal-broth, 151 - 
Veil, 25, 43 

Ventilation of nursery, 144 
Vomiting, 117 
after feeding, 92 

Walking, 35 
Weaning, 65 

a bottle-fed baby, 67 

a breast-fed baby, 65 
Weight, 30 

average, during first year, 32 

-chart, 31 

loss of, 92 
Wetnurse, the, 145 

diet of the, 146 
Whey, 148 
Whole milk, 94 
Whooping-cough, 126 

symptoms of, 128 
Window-board, 144 
Worms, 143 
Wounds, 113 



DEC 1 6 1903 



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